法舒地尔治疗慢性肺源性心脏病心力衰竭的疗效及对患者血清NO、内皮素水平的影响研究

Clinical effect of fasudil in heart failure induced by chronic pneumocardial disease and the influence in serum level of NO and ET-1

目的分析法舒地尔治疗慢性肺源性心脏病心力衰竭的疗效及对患者血清NO、内皮素(ET-1)水平的影响。方法以2013年9月—2016年9月宝鸡市中心医院收治的慢性肺源性心脏病心力衰竭患者100例为研究对象,根据随机数字表法分为观察组和对照组,每组50例。对照组患者均接受常规治疗,观察组在常规治疗的基础上加用盐酸法舒地尔注射液,两组均连续治疗2周。比较两组的临床疗效、血氧分压(Pa O2)、二氧化碳分压(Pa CO2)、三尖瓣反流速度、右室流出道内径(RVOT)、左室射血分数(LVEF)以及血清生化指标(NO、ET-1)的水平。结果治疗结束后,观察组的总有效率为86.00%,高于对照组的72.00%,但差异无统计学意义。治疗前,两组的Pa O2、Pa CO2、三尖瓣反流速度、RVOT、LVEF比较,差异均无统计学意义;治疗结束后,两组的Pa O2、LVEF较治疗前显著升高,Pa CO2、三尖瓣反流速度、RVOT较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的Pa O2、LVEF显著高于对照组,Pa CO2、三尖瓣反流速度、RVOT显著低于对照组,差异有统计学意义(P<0.05)。治疗前,两组的血清NO、ET-1比较,差异均无统计学意义;治疗结束后,两组的血清NO较治疗前显著升高,血清ET-1较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的血清NO水平显著高于对照组,血清ET-1水平显著低于对照组,差异有统计学意义(P<0.05)。结论法舒地尔辅助治疗慢性肺源性心脏病心力衰竭可有效提高临床疗效,改善患者的临床症状,作用机制可能与降低血清ET-1水平,升高血清NO水平有关。

Objective To investigate the clinical effect of fasudil in heart failure induced by chronic pneumocardial disease and the influence in serum level of NO and ET-1. Methods 100 cases of patients with heart failure induced by chronic pneumocardial disease in our hospital from September 2013 to September 2016 were selected and divided into observation group and control group, 50 cases in each group. Patients in the control group were treated with conventional therapy, and in the observation group were treated with fasudil based on the conventional therapy. Compared the clinical effect, blood oxygen partial pressure （PaO2）, CO2 partial pressure （PaCO2）, tricuspid regurgitation speed, fight ventricular outflow tract inside diameter（RVOT）, left ventricular ejection fraction （LVEF） and serum biochemical indexes （NO and ET-1） levels. Results After treatment, the total effective rate of the observation group was significantly higher than control group （P 〈 0.05）. PaO2, LVEF, serum level of NO of the two groups were significantly higher, PaCO2,tricuspid regurgitation speed, RVOT, serum level of ET-1 significantly lower than before treatment （P 〈0.05）, and the PaO2, LVEF, serum level of NO of observation group were significantly higher, PaCO2, tricuspid regurgitation speed, RVOT, serum level of ET-1 of observation group were significantly lower than control group （P 〈 0.05）. Conclusion Fasudil had remarkable clinical effect in heart failure induced by chronic pneumocardial disease,and improve the patient＇s clinical symptoms, adjust the serum level of NO and ET-1.