Rho激酶抑制剂对急性左心衰治疗中的临床应用价值

Clinical Value of Rho Kinase Inhibitor in the Treatment of Acute Left Heart Failure(ALHF)

目的:研究急性左心衰(Acute left heart failure,ALHF)治疗中Rho激酶抑制剂的应用价值。方法:采用前瞻性分析方法,研究对象为2019年1月至2020年1月入院的62例ALHF患者,参考简单随机分组法分为两个小组,一个小组为对照组,另一个小组为研究组,各31例;两组均给予常规治疗,对照组基于常规治疗选用呋塞米、螺内酯治疗,研究组基于常规治疗联用呋塞米、螺内酯及Rho激酶抑制剂(盐酸法舒地尔)治疗;比较两组治疗前后心功能指标、心肌酶谱指标水平与治疗后总有效率、不良反应发生率。结果:两组治疗前左心室收缩末期容积(Left ventricular end-systolic volum,LVSDV)、左心室舒张末期容积(Left ventricular end-diastolic volume,LVEDV)、左心室射血分数(Left ventricular ejection fraction,LVEF)、肌酸激酶同工酶(Creatine Kinase Isoenzyme-MB,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、谷草转氨酶(Aspartate aminotransferase,AST)水平无差异(P>0.05);两组治疗后较治疗前LVEF更高,LVSDV、LVEDV、CK-MB、LDH及AST水平更低(P<0.05);研究组较对照组治疗后LVEF、总有效率更高,LVSDV、LVEDV、CK-MB、LDH及AST水平更低(P<0.05),且两组患者治疗前后的差值进行组间比较,差异均有统计学意义(P<0.05);两组治疗后不良反应发生率无差异(P>0.05)。结论:ALHF治疗中Rho激酶抑制剂的应用效果显著,可有效改善心肌酶谱水平,促使心功能快速恢复,且不良反应少。

Objective:To study the application value of Rho kinase inhibitor in the treatment of acute left heart failure(ALHF).Methods:Retrospective analysis was performed on 62 ALHF patients admitted from January 2019 to January 2020.The subjects were divided into control group and study group by referring to the random number table method,with 31 patients in each group.Both groups were given conventional treatment.The control group was treated with furtimox and spironolactone based on conventional treatment,while the study group was treated with furtimox,spironolactone and Rho kinase inhibitor(Fasudil hydrochloride)based on conventional treatment.Cardiac function index,myocardial enzyme spectrum index,total effective rate and adverse reaction rate were compared between the two groups before and after treatment.Results:Before treatment,there was no difference between the two groups in left ventricular end-systolic volum(LVSDV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),Creatine Kinase Isoenzyme-MB(CK-MB),lactate dehydrogenase,LDH and Aspartate aminotransferase(AST)levels(P>0.05).LVEF after treatment was higher,and LVSDV,LVEDV,CK-MB,LDH and AST levels were lower than those before treatment in both groups(P<0.05).After treatment,LVEF and total effective rate in the study group were higher than those in the control group,and LVSDV,LVEDV,CK-MB,LDH and AST levels were lower(P<0.05).The difference values between the two groups before and after treatment were compared,and the differences were statistically significant(P<0.05).There was no difference in the incidence of adverse reactions after treatment between the two groups(P>0.05).Conclusion:The application of Rho kinase inhibitor in ALHF treatment has a significant effect,can effectively improve the level of myocardial enzyme spectrum,and can promote the recovery of cardiac function,with fewer adverse reactions.