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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 analyze the curative effect of fasudil on patients with chronic cor pulmonale heart failure and its effect on serum NO and endothelin (ET-1) levels. Methods From September 2013 to September 2016, 100 cases of heart failure patients with chronic cor pulmonale admitted to Baoji Central Hospital were enrolled and divided into observation group and control group according to random number table method, with 50 cases in each group. Patients in the control group received routine treatment. The observation group was given Fasudil Hydrochloride Injection on the basis of routine treatment. Both groups were treated continuously for 2 weeks. The clinical effects, Pa O2, PaCO 2, tricuspid regurgitation velocity, RVOT, LVEF and serum Biochemical indicators (NO, ET-1) levels. Results After treatment, the total effective rate in the observation group was 86.00%, which was higher than 72.00% in the control group, but the difference was not statistically significant. Before treatment, the PaO2, Pa CO2, tricuspid regurgitation velocity, RVOT and LVEF were not significantly different between the two groups. PaO2 and LVEF in both groups were significantly increased after treatment CO2, tricuspid regurgitation velocity and RVOT were significantly lower than those before treatment (P <0.05), and PaO2 and LVEF in the observation group were significantly higher than those in the control group RVOT velocity was significantly lower than control group, the difference was statistically significant (P <0.05). Before treatment, serum NO and ET-1 levels in the two groups had no significant difference. After the treatment, serum NO in the two groups was significantly higher than before treatment, serum ET-1 was significantly lower than before treatment, the same group treatment The difference was statistically significant before and after (P <0.05). The serum NO level in the observation group was significantly higher than that in the control group, and the serum ET-1 level was significantly lower than that in the control group (P <0.05). Conclusion Fasudil adjuvant treatment of heart failure of chronic cor pulmonale can effectively improve the clinical curative effect and improve the clinical symptoms of the patients. The mechanism may be related to the decrease of serum ET-1 level and the increase of serum NO level.