法舒地尔联合舒利迭治疗COPD合并肺动脉高压作用机制研究  

Mechanism of fasudil combined Seretide in treating COPD complicated pulmonary artery hypertension

作　　者：卢坤琴[1] 陈龙[1] 张华俊[1] 余秋里 朱世祥[1] 杨志芸 葛艳[1] 阚海峰[1] 

机构地区：[1]如皋市人民医院呼吸内科,江苏南通226500

出　　处：《心血管康复医学杂志》2017年第2期182-185,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2013年度南通市科技局课题(HS13929)~~

摘　　要：目的:探讨法舒地尔联合沙美特罗替卡松粉吸入剂(舒利迭)治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)的作用机制。方法:选择我院2013年1月至2014年10月入住呼吸科符合COPD及PAH诊断标准的患者120例。根据随机数字表法,患者被随机均分为常规治疗组、法舒地尔组(在常规治疗组基础上接受法舒地尔静滴)和联合治疗组(在法舒地尔组基础上联合舒利迭治疗)。比较三组患者治疗前后一氧化氮(NO)、内皮素1(ET-1)、C反应蛋白(CRP)水平和血沉(ESR)等指标。结果:与治疗前比较,治疗两周后三组的CRP、ESR和ET-1水平均显著降低,NO水平显著升高(P<0.05或<0.01);且与常规治疗组治疗后比较,法舒地尔组和联合治疗组CRP[(14.8±3.3)mg/L比(12.9±3.6)mg/L比(11.4±3.4)mg/L]、ESR[(37.3±8.9)mm/h比(32.9±8.8)mm/h比(29.3±5.6)mm/h]和ET-1[(63.1±11.2)ng/L比(57.5±8.1)ng/L比(53.1±8.9)ng/L]水平降低更显著,NO水平[(70.2±10.7)μmol/L比(76.0±8.0)μmol/L比(80.5±11.3)μmol/L]升高更显著,P<0.05或<0.01;与法舒地尔组比较,联合治疗组CRP、ESR和ET-1水平降低更显著,NO水平升高更显著(P均<0.05)。结论:盐酸法舒地尔联合舒利迭治疗COPD合并PAH能更显著地降低血沉、C反应蛋白和内皮素1水平,提高NO水平,可能改善患者预后,值得推广。Objective.. To explore mechanism of fasudil combined salmeterol and fluticasone propionate powder for inhalation （Seretide） in treating chronic obstructive pulmonary disease （COPD） complicated pulmonary artery hypertension （PAH）. Methods： A total of 120 patients accorded with diagnostic standards of COPD and PAH, who hospitalized in our department from Jan 2013 to Oct 2014, were selected. According to random number table method, patients were randomly and equally divided into routine treatment group, fasudil group （received intravenous drip of fasudil based on routine treatment group） and combined treatment group （received additional Serctide therapy based on fasudil group）. Levels of nitric oxide （NO）, endothelin- 1 （ET-1）, C reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were measured and compared among three groups before and after treatment. Results： Compared with before treatment, after two-week treatment, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in three groups, P〈0. 05 or〈 0.01 ; compared with routine treatment group after treatment, there were significant reductions in levels of CRP E （14. 8 ± 3.3） mg/L vs. （12.9 ± 3.6） mg/L vs. （11.4 ± 3.4） mg/L], ESR [（37. 3 ±8. 9） mm/h vs. （32.9 ± 8. 8） mm/h vs. （29.3 ± 5.6） mm/h] and ET-1 [ （63.1 ± 11.2） ng/L vs. （57.5 ± 8, 1） ng/L vs. （53.1 ± 8. 9） ng/L], and significant rise in NO level [ （70. 2 ± 10.7） μmol/L vs. （76. 0 ± 8. 0） μmol/L vs. （80.5 ± 11.3） μmol/L] in fasudil group and combined treatment group, P〈0.05 or〈0. 01; compared with fasudil group, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in combined treatment, P〈0. 05 all. Conclusion： Fasudil hydrochloride combined Seretide can significantly reduce levels of ESR, CRP and ET-1, and increase NO level in COPD ＋ PAH patients. It may improve prognosis in these patients,

关 键 词：肺疾病 慢性阻塞性 高血压 肺性 一氧化氮 

分 类 号：R544[医药卫生—心血管疾病]