R ho 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 、 LD H 、 CK‐MB 水平的影响

摘要

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 , LV‐EDV ,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 myocar ‐dial damage , and it＇s safe and reliable , which is worth extending .%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.