薛忠文,高德全,余清,杨光远
XUE Zhongwen,GAO Dequan,YU Qing,YANG Guangyuan

• 1:房山区良乡医院心内科
• 2:佳木斯大学附属第一医院心内科

摘要(Abstract)：

目的:探讨法舒地尔对高血压性心脏病患者左室舒缩功能、血清B型尿钠肽(BNP)、Ⅲ型前胶原氨基末端肽(PⅢNP)水平的影响。方法:60例高血压性心脏病患者随机均分为对照组和治疗组,对照组患者给予降压、利尿及抗心衰药物治疗,治疗组在对照组治疗的基础上给予法舒地尔静脉滴注,两组疗程均为2周;于治疗前、治疗2周时及3月时分别测量血压、心率并进行超声心动图检查,计算左心室质量指数(LVMI)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)及左室舒张末期指数(LVEDVI),同时检测血清B型尿钠肽(BNP)、Ⅲ型前胶原氨基末端肽(PⅢNP)水平,记录发生肝肾功能异常患者例数等不良反应。结果:两组患者治疗3个月时,LVEF、LVMI、LVEDVI及LVESVI较治疗前和治疗2周时下降,治疗组LVEDVI及LVESVI下降更明显(P<0.05);两组患者治疗2周及治疗3个月时,BNP水平均低于治疗前,而PⅢNP仅治疗2周时低于治疗前(P<0.05);与对照组相比,治疗组治疗2周时PIIINP、BNP下降明显,差异有统计学意义(P<0.05);在治疗期间及治疗结束时,两组均未出现肝肾功能异常等不良反应。结论:高血压性心脏病患者在常规治疗基础上联合法舒地尔,可进一步抑制左室的扩张和纤维化,减轻左室重构的发生发展。
Objective: To investigate the effect of fasudil on the left ventricular systolic and diastolic function,the serum levels of Type B natriuretic peptide( BNP) and N-terminal propeptide of type III procollagen( P Ⅲ NP) in patients with hypertensive heart disease. Methods: Sixty cases of patients with hypertensive heart disease were randomly divided into experimental group and control group. The control group were treated with antihypertensive,diuretic,and anti heart failure drug therapy,the treatment group was given fasudil intravenously based on the treatment in control group,two groups were treated for 2 weeks. Before treatment,2 weeks and 3 months after treatment,blood pressure and heart rate were measured respectively,and echocardiography was performed to calculate the left ventricular mass index( LVMI),left ventricular end diastolic volume( LVEDV),left ventricular ejection fraction( LVEF) and left ventricular end diastolic index( LVEDVI),and the serum levels of PⅢNp and BNP were detected. Adverse reaction were observed. Results: After treating for 3 months,LVEF,LVMI,LVEDVI and LVESVI in the two groups decreased compared with these parameters before treatment and 2 weeks after treatment,and the changes of LVEDVI and LVESVI in the treatment group were more significant. The levels of BNP in the two groups in 2 weeks and 3 months after treatment were lower than those before treatment,and PIIINP levels in the two groups in 2 weeks after treatment were lower than those before treatment( P < 0. 05). Compared with control group,after 2 weeks of treatment,PIIINP and BNP in the treatment group decreased significantly( P < 0. 05). There was no adverse reaction such as liver and kidney dysfunction in the two groups. Conclusion: The combination of fasudil with conventional therapy can reduce the expansion and fibrosis of left ventricle and reduce the occurrence and development of left ventricular remodeling in patients with heart failure caused by hypertensive heart disease.

关键词(KeyWords)： 法舒地尔;高血压性心脏病;心室重构;Ⅲ型前胶原氨基末端肽;B型尿钠肽
fasudil;hypertensive heart disease;ventricular remodeling;Type Ⅲ procollagen amino terminal peptide;B type urinary natriuretic peptide

Abstract:

Keywords:

基金项目(Foundation): 首都卫生发展科研专项项目(首发2014-4-7071)

作者(Author): 薛忠文,高德全,余清,杨光远
XUE Zhongwen,GAO Dequan,YU Qing,YANG Guangyuan

DOI: 10.19367/j.cnki.1000-2707.2017.09.013

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