法舒地尔治疗老年慢性肺源性心脏病临床疗效及其机制的随机对照研究

发布时间：2018-02-25 05:19

本文关键词： 肺心病法舒地尔 C反应蛋白质利钠肽脑随机对照试验　出处：《中国全科医学》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨法舒地尔治疗老年慢性肺源性心脏病(CPHD)的临床疗效及其机制。方法前瞻性选取2014年10月—2015年3月西安市第二医院呼吸内科收治的老年CPHD患者76例为研究对象,采用随机数字表法分为治疗组38例和对照组38例。治疗组在CPHD内科常规药物治疗的基础上给予法舒地尔注射液静脉滴注;对照组在CPHD内科常规药物治疗的基础上给予0.9%氯化钠注射液静脉滴注作为对照,共治疗14 d。治疗前及治疗后测定血压、心率、血气分析〔动脉血氧分压(Pa O_2)、二氧化碳分压(Pa CO_2)〕、肺动脉收缩压(s PAP);治疗前及治疗第7、14天检测超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-pro BNP)水平。观察治疗期间不良事件。结果对照组因心力衰竭死亡1例,脱落率1.3%。治疗前及治疗后,治疗组与对照组患者收缩压、舒张压、心率比较,差异均无统计学意义(P0.05)。治疗前,治疗组与对照组患者Pa O_2、Pa CO_2、s PAP比较,差异均无统计学意义(P0.05)。治疗后,治疗组较对照组患者Pa O_2升高,Pa CO_2、s PAP降低(P0.05)。hs-CRP、NT-pro BNP水平治疗方法与治疗时间存在交互作用(P0.05),治疗方法主效应显著(P0.05),治疗时间主效应显著(P0.05)。治疗前,治疗组与对照组患者hs-CRP、NT-pro BNP水平比较,差异均无统计学意义(P0.05);治疗第7、14天,治疗组患者hs-CRP、NT-pro BNP水平较对照组降低(P0.05)。治疗期间,少数患者出现头昏(治疗组3例,对照组2例)、头痛(治疗组1例,对照组1例)等不适,停药后症状均消失,无其他明显药物不良反应。结论法舒地尔治疗老年CPHD患者可提高Pa O_2,降低Pa CO_2、s PAP、hs-CRP及NT-pro BNP水平,不增加不良反应。
[Abstract]:Objective to investigate the clinical efficacy and mechanism of fasudil in the treatment of elderly patients with chronic pulmonary heart disease (CPHD). Methods 76 elderly CPHD patients admitted to Department of Respiratory Medicine of Xi'an second Hospital from October 2014 to March 2015 were prospectively selected as subjects. The treatment group was divided into treatment group (n = 38) and control group (n = 38). The control group was given intravenous drip of 0.9% sodium chloride injection on the basis of routine medicine treatment of CPHD. Blood pressure and heart rate were measured before and after treatment for 14 days. Arterial partial pressure of oxygen (Pao _ 2), partial pressure of carbon dioxide (CO _ 2), pulmonary arterial systolic pressure (PAPP) were measured before treatment and on day 714 after treatment, the levels of NT-pro BNPs of N-terminal brain natriuretic peptide (NT-pro BNPs) were measured before treatment and on day 714 after treatment. Results one patient died of heart failure in the control group. Before and after treatment, there was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the treatment group and the control group (P 0.05). After treatment, there was no significant difference in P0.05. after treatment, the treatment group had higher PCO2S PAP than the control group. The level of P0.05hs-CRPT-pro BNP in the treatment group had an interaction with the time of treatment. The main effect of the treatment method was significantly higher than that of the control group (P0.055.The main effect of the treatment time was significant P0.05. before treatment, there was no significant difference between the treatment method and the treatment time. The levels of hs-CRPnT-pro BNP in the treatment group were not significantly different from those in the control group (P 0.05), the level of hs-CRPnT-pro BNP in the treatment group was significantly lower than that in the control group on the 14th day of treatment (3 cases in the treatment group, 3 cases in the treatment group, 3 cases in the treatment group, 3 cases in the treatment group, 3 cases in the treatment group, 3 cases in the treatment group, and 3 cases in the treatment group). In the control group, 2 cases were ill with headache (1 case in the treatment group and 1 case in the control group), the symptoms disappeared after stopping the treatment, and there were no obvious adverse drug reactions. Conclusion the treatment of fasudil can increase Paco _ 2 and decrease the levels of PAPHs-CRP and NT-pro BNP in elderly patients with CPHD. There was no increase in adverse reactions.
【作者单位】：陕西省西安市第二医院呼吸内科;
【基金】：西安市卫生局科研项目(2012004,J2014009)
【分类号】：R541.5

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