Rho激酶抑制剂联合呋塞米及螺内酯对急性左心衰患者心功能及血清AST、LDH、CK-MB水平的影响  

Influence of Rho kinase inhibitor combined furosemide and spironolactone on cardiac function,serum levels of AST,LDH and CK-MB in patients with acute left heart failure

作　　者：付孝清 黎昌宏 谭杰 FU Xiao-qing;LI Chang-hong;TAN Jie(Department of Cardiology,People's Hospital of Kaizhou District,Chongqing,405400,China)

机构地区：[1]重庆市开州区人民医院心血管内科,重庆405400 [2]重庆市开州区人民医院急诊科,重庆405400

出　　处：《心血管康复医学杂志》2019年第4期461-466,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨Rho激酶抑制剂(RKI)联合呋塞米及螺内酯在急性左心衰(ALHF)治疗中的临床应用价值。方法: 2016年4月~2018年2月我院收治的94例ALHF患者被随机均分为利尿剂组(常规治疗基础上接受呋塞米及螺内酯)和三联治疗组(在利尿剂组基础上加用RKI—盐酸法舒地尔),两组均连续治疗7d。观察比较两组治疗前后LVESV、LVEDV、LVEF、血清谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)水平,临床疗效。结果:三联治疗组治疗总有效率显著高于利尿剂组(95.75%比82.98%), P =0.045。与治疗前比较,治疗后两组LVEF显著升高,LVESV、LVEDV、血清AST、LDH、CK-MB水平均显著降低, P 均=0.001;与利尿剂组比较,三联治疗组治疗后LVEF[(48.27±5.95)%比(55.14±6.74)%]升高更显著,LVESV[(86.29±10.41)ml比(65.96±9.84)ml]、LVEDV [(133.71±13.42)ml比(120.35±11.25)ml]、血清AST[(81.23±10.44)U/L比(57.58±8.42)U/L]、LDH[(184.24±13.51)U/L比(124.65±12.42)U/L]、CK-MB[(187.84±13.45)U/L比(132.54±11.69) U/L]水平降低更显著, P 均=0.001。两组不良反应发生率无显著差异, P 均>0.05。结论: Rho激酶抑制剂联合呋塞米与螺内酯治疗ALHF效果显著,可显著改善心功能、减轻心肌损害,且安全可靠,值得推广。Objective: To explore application value of Rho kinase inhibitor (RKI) combined furosemide and spironolactone in patients with acute left heart failure (ALHF). Methods: A total of 94 ALHF patients were randomly and equally divided into diuretic group (received furosemide and spironolactone based on routine treatment) and triple therapy group (received RKI--fasudil hydrochloride based on diuretic group),both groups were continuously treated for 7d. LVESV,LVEDV,LVEF,serum levels of aspartate transaminase (AST),lactate dehydrogenase (LDH) and creatine kinase isoenzyme MB (CK-MB) before and after treatment,therapeutic effects were observed and compared between two groups. Results: Total effective rate of triple therapy group was significantly higher than that of diuretic group (95.75% vs. 82.98%), P =0.045. Compared with before treatment,there was significant rise in LVEF,and significant reductions in LVESV,LVEDV,serum levels of AST,LDH and CK-MB in two groups after treatment, P =0.001 all;compared with diuretic group after treatment,there was significant rise in LVEF [(48.27±5.95)% vs.(55.14±6.74)%],and significant reductions in LVESV [(86.29±10.41)ml vs.(65.96±9.84)ml],LVEDV [(133.71±13.42)ml vs.(120.35±11.25)ml],serum levels of AST [(81.23±10.44)U/L vs.(57.58±8.42)U/L],LDH[(184.24±13.51)U/Lvs.(124.65±12.42)U/L]and CK-MB[(187.84±13.45) U/L vs.(132.54±11.69) U/L] in triple therapy group, P =0.001 all. There was no significant difference in adverse reactions during treatment between two groups, P >0.05 both. Conclusion: Rho kinase inhibitor combined furosemide and spironolactone can significantly improve cardiac function and reduce myocardial damage,and it's safe and reliable,which is worth extending.

关 键 词：心力衰竭 RHO相关激酶类 呋塞米 螺内酯 

分 类 号：R541.6[医药卫生—心血管疾病]