法舒地尔联合呋塞米、螺内酯对急性左心功能衰竭患者心功能及血清AST、LDH、CK-MB水平的影响  

Effects of fasudil combined with furosemide and spironolactone on cardiac function and serum AST,LDH and CK-MB levels in patients with acute left heart failure

作　　者：马乔炎[1] 张平[1] 曹倩[1] 张建秀[1] 孙广江[1] Ma Qiaoyan;Zhang Ping;Cao Qian;Zhang Jianxiu;Sun Guangjiang(Cardiac Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100000,China)

机构地区：[1]首都医科大学附属北京康复医院心脏康复中心,100000

出　　处：《疑难病杂志》2020年第5期443-446,451,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：北京市自然科学基金资助项目(L172031)。

摘　　要：目的观察Rho激酶抑制剂法舒地尔联合呋塞米及螺内酯对急性左心功能衰竭(ALHF)患者心功能及血清天冬氨酸基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸肌酶同工酶(CK-MB)水平的影响。方法选取2016年1月—2018年12月首都医科大学附属北京康复医院心脏康复中心收治ALHF患者90例,按随机数字表法分成对照组(45例)与观察组(45例)。对照组患者采取常规治疗配合呋塞米及螺内酯,观察组患者在对照组基础上联合法舒地尔治疗。比较2组临床疗效,治疗前后心功能,血清AST、LDH、CK-MB水平,生存质量表(SF-36)评分,步行6 min距离,不良反应发生率。结果观察组治疗总有效率为97.78%,高于对照组的84.44%(χ^2=4.939,P=0.026)。治疗后2组患者心功能指标,血清AST、LDH、CK-MB水平,SF-36评分,6 min步行距离明显改善,且观察组改善明显优于对照组(t/P=7.879/0.000、3.443/0.000、10.314/0.000、12.396/0.000、12.318/0.000、3.967/0.000、12.671/0.000),2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论采取Rho激酶抑制剂联合呋塞米及螺内酯治疗急性左心功能衰竭,可明显改善患者心脏功能,降低血清AST、LDH、CK-MB表达水平,提升患者生活质量评分与6 min步行距离。Objective To observe the effect of Rho kinase inhibitor fasudil combined with furosemide and spironolactone on cardiac function and serum aspartate transferase(AST),lactate dehydrogenase(LDH)and creatine MB(CK-MB)levels in patients with acute left heart failure(ALHF).Methods From January 2016 to December 2018,90 patients with ALHF were enrolled in the heart rehabilitation center of Beijing Rehabilitation Hospital Affiliated to Capital Medical University.They were divided into control group(45 cases)and observation group(45 cases)according to the random number table method.The patients in the control group were treated with furosemide and spironolactone,while the patients in the observation group were treated with fasudil based on the control group.The clinical effect,cardiac function,serum AST,LDH and CK-MB levels,SF-36 scores,6 min walking distance and adverse reactions were compared before and after treatment.Results The total effective rate of the observation group was 97.78%,higher than 84.44%of the control group(χ^2=4.939,P=0.026).After treatment,the heart function index,serum AST,LDH,CK-MB level,SF-36 score,6 min walking distance were significantly improved in the two groups,and the improvement in the observation group was significantly better than that in the control group(t/P=7.879/0.000,3.443/0.000,10.314/0.000,12.396/0.000,12.318/0.000,3.967/0.000,12.671/0.000).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Rho kinase inhibitor combined with furosemide and spironolactone in the treatment of acute left heart failure can significantly improve the cardiac function of patients,reduce the expression level of serum AST,LDH and CK-MB,and improve the patients'quality of life score and 6-min walking distance.

关 键 词：Rho激酶抑制剂 呋塞米 螺内酯 联合治疗 左心功能衰竭 急性 心功能 天冬氨酸氨基转移酶 乳酸脱氢酶 肌酸肌酶同工酶 

分 类 号：R54[医药卫生—心血管疾病]