盐酸法舒地尔对急性心肌梗死患者血液流变学和血清炎性细胞因子的影响研究

Clinical study on changes of indexes of hemorheology and inflammatory factors of fasudil intervention on acute myocardial infarction

目的：观察盐酸法舒地尔干预治疗急性心肌梗死（AMI）患者的血液流变学和血清炎性细胞因子的变化，探讨盐酸法舒地尔在 AMI 中可能的作用及机制。方法选取120例确诊为 AMI 患者，采用随机数字表法分为治疗组（60例）和对照组（60例）。对照组给予常规治疗，治疗组在此基础上给予盐酸法舒地尔30 mg 静脉滴注2／d，两组均治疗14 d。检测两组治疗前后血液流变学和血清炎性细胞因子（C 反应蛋白、IL-1β、IL-6、IL-10、TNF-β）的含量。结果两组治疗后全血黏度（低切、中切、高切）及血浆黏度均比治疗前明显降低（P ＜0.05），治疗组治疗后的红细胞压积（HCT）比治疗前显著降低（P ＜0．05），而对照组治疗后的HCT 未见明显降低（P ＞0．05）。并且，治疗2周后，治疗组的全血黏度（低切、中切、高切）及血浆黏度比对照组明显降低（P ＜0．05），HCT 无明显降低（P ＞0．05）。两组治疗后 CRP、IL-1β、IL-6和 TNF-β比治疗前均显著降低（P ＜0．05），IL-10显著升高（P ＜0．05），并且，治疗组治疗后与对照组治疗后相比，上述指标的变化更明显（P ＜0.05）。结论盐酸法舒地尔可能是通过改善血液流变学，并减轻 AMI 后的炎性反应来发挥其治疗作用的，且盐酸法舒地尔干预的治疗方法较常规治疗的短期效果好。

Objective To investigate the possible mechanisms of fasudil on acute myocardial infarction （AMI）by observing the changes of hemorheology and inflammatory factors.Methods 120 patients diagnosed AMI in our hospital were randomly divided into the two groups：60 cases in the control group were given the conventional treat-ment and the other 60 cases in the treatment group were added fasudil for 2 weeks based on that.Then we analyzed the changes of hemorheology and inflammatory factors.Results 2 weeks later,the whole blood restore viscosity,plasma viscosity,CRP,IL -1β,IL -6 and TNF -βin the two groups were all obviously decreased than those of before（P 〈0.05）,while,packed cell volume in the treatment group was obviously decreased as well （P 〈0.05）.Furthermore, the changes in the treatment group were more significant compared with the controlled group （P 〈0.05）.Conclusion Fasudil intervention on AMI can improve the situation of hemorheology and relieve the inflammation more effectively than conventional treatment.