法舒地尔对心力衰竭患者心室结构的改善作用及临床疗效研究

Study for improving effect on ventricular structure and clinic effect of fasudil in patients with heart failure

目的:观察盐酸法舒地尔对慢性心力衰竭患者的临床疗效。方法:选择我院心内科治疗的慢性心力衰竭患者134例,采用随机数字法分为常规治疗组和法舒地尔组,每组67例。治疗3个月,比较两组治疗前后左室射血分数(LVEF)、左心室舒张末内径(LVEDd)、左心室收缩末期内径(LVESd)的差异及脑钠肽(BNP)、内皮素1(ET-1)和心钠素(ANP)水平的变化。结果:与法舒地尔组治疗前和常规治疗组治疗后比较,治疗3个月后法舒地尔组LVEDd[(58.20±8.44)mm、(58.22±10.21)mm比(51.24±7.37)mm]、LVESd[(47.52±6.51)mm、(47.56±6.54)mm比(41.24±5.33)mm]明显减小,BNP[(381.35±62.48)μg/L、(377.82±61.46)μg/L比(294.52±51.33)μg/L]、ET-1[(81.93±13.53)μg/L、(81.32±12.63)μg/L比(68.44±11.42)μg/L]和ANP[(215.33±39.72)μg/L、(210.51±36.17)μg/L比(172.26±27.54)μg/L]水平显著降低,LVEF[(29.69±4.08)%、(29.94±4.25)%比(37.47±5.26)%]显著提高(P均<0.01)。法舒地尔组治疗后临床有效率显著高于常规治疗组(94.0%比80.6%,P=0.019)。两组临床不良反应发生率无显著性差异(P>0.05)。结论:盐酸法舒地尔可以显著减少慢性心力衰竭患者脑钠肽、内皮素1和心钠素水平,延缓心室重塑、改善心功能,临床疗效显著,使用安全。

Objective： To observe clinical therapeutic effect of fasudil hydrochloride in patients with chronic heart failure （CHF）. Methods： A total of 134 CHF cases were selected from our department. According to random number table, they were randomly and equally divided into routine treatment group and fasudil group, both groups were treated for three months. Left ventricular ejection fraction （LVEF）, left ventricular end-diastolic dimension （LVEDd）, left ventricular end-systolic dimension （LVESd）, levels of brain natriuretic peptide （BNP）, endothelin （ET） -1 and atrial natriuretic peptide （ANP） were compared between two groups before and after treatment. Resuits： Compared with fasudil group before treatment and routine treatment group after treatment, there were significant reductions in LVEDd [ （58.20±8.44） mm, （58.22± 10.21） mm vs. （51.24±7.37） mm], LVESd [（47.52 ±6.51） mm, （47.56±6.54） mmvs. （41.24±5.33） mm], levels of BNP [ （381.35±62.48）μg/L, （377.82-± 61.46）μg/L vs. （294. 52 ± 51.33）μg/L], ET-1 [ （81.93 ± 13.53μg/L, （81.32 ± 12.63）μg/L vs. （68.44 ± 11.42）μg/L] and ANP [（215.33 ± 39.72）μg/L, （210.51± 36.17）μg/L vs. （172.26 ± 27.54）μg/L], and significant rise in LVEF [ （29.69 ± 4. 08） %, （29.94 ± 4.25） % vs. （37.47± 5.26） %] in fasudil group after three-month treatment,P〈0.01 all. Total effective rate of fasudil group was significantly higher than that of routine treatment group （94.0% vs. 80.6%, P = 0. 019）. There was no significant difference in incidence rate of adverse reactions between two groups, P〉0.05. Conclusion： Fasudil hydrochloride can significantly reduce levels of BNP, ET-1 and ANP, delay ventricular remodeling and improve cardiac function in CHF patients. The therapeutic effect is significant and safety is good.