法舒地尔治疗老年舒张性左心衰竭相关性肺动脉高压的有效性及安全性研究

摘要

Objective To evaluate the efficacy and safety of fasudil in diastolic left ventricular failure ( LVF ) related pulmonary hypertension ( PH ). Methods From January 2009 to August 2011, 36 elderly PH patients were divided into groups test ( 18 cases ) and control ( 18 cases ). Both groups were given drugs for diastolic LVF including p - receptor blocker, angio-tensin - converting enzyme inhibitors, etc. But test group received additional fasudil, 30 mg, iv gtt. twice/d, 2 weeks. Six - min walking distance ( WD ), pulmonary arterial systolic pressure ( PASP ), arterial oxygen partial pressure ( PaO2 ) of 2 groups and blood pressure ( BP ), heart rate ( HR ) of test group were observed before and after treatment. Results Compared with control group, 6 - min WD of test group was longer ( P < 0. 05 ), SPAP lower ( P < 0. 05 ) and arterial PaO2 higher ( P < 0. 05 ), BP and HR did not change significantly ( P > 0. 05 ). Conclusion Fasudil, which can reduce effectively PH of patients with diastolic LVF and improve the ability of daily activities, is safe and effective.%目的 探讨法舒地尔治疗老年舒张性左心衰竭相关性肺动脉高压的有效性及安全性.方法 对我院老年病科2009年1月-2011年8月住院的老年肺动脉高压患者进行筛选,符合标准者36例,其中实验组18例,对照组18例.两组均给予治疗舒张性心力衰竭的药物,包括β-受体阻滞剂、血管紧张素转换酶抑制剂等,暂不予钙离子拮抗剂.实验组在此基础上给予法舒地尔30 mg静脉滴注,2次/d.两组疗程为2周.观察两组患者治疗前后6 min步行距离、肺动脉收缩压、动脉血氧分压及实验组治疗前后血压、心率的变化情况.结果 治疗前两组6 min步行距离、收缩期肺动脉压力(SPAP)及PaO2比较,差异均无统计学意义(P＞0.05),治疗后实验组6 min步行距离增大,SPAP明显下降,PaO2明显升高,且改善程度均优于对照组,差异有统计学意义(P＜0.05);实验组治疗前后血压、心率比较,差异均无统计学意义(P＞0.05).结论 法舒地尔可有效减轻老年舒张性左心衰竭患者肺动脉高压,改善日常活动能力,且安全有效.