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目的:观察法舒地尔治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压的疗效。方法:选取2013年8月至2014年8月在东莞市塘厦医院和广东医学院附属医院住院确诊的COPD合并肺动脉高压患者100例,按数字随机法分两组:治疗组和对照组各50例。两组均给予基础治疗,对照组加用酚妥拉明10 mg/d缓慢静脉滴注0.05 mg/min,1次/d;治疗组在此基础上用盐酸法舒地尔30 mg溶于0.9%氯化钠注射液100 m L,静脉滴注,2次/d。两组患者均治疗14 d。检测两组患者治疗前后血浆N-BNP、D-二聚体水平和肺动脉收缩压。结果:治疗前,两组患者相关指标,差异无统计学意义(P>0.05);治疗14 d后,两组患者的血浆N-BNP、D-二聚体水平和肺动脉收缩压均较治疗前显著下降,差异具有统计学意义(P<0.05),但治疗组患者的下降更显著,差异具有统计学意义(P<0.05);治疗组患者未发生与法舒地尔相关的不良反应。结论:法舒地尔治疗慢性阻塞性肺疾病并肺动脉高压安全有效,其机制可能是通过降低血浆N-BNP、D-二聚体水平,从而降低肺动脉高压,改善心肺功能。
Objective: To observe the efficacy of fasudil in the treatment of chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension. Methods: A total of 100 COPD patients with pulmonary hypertension diagnosed in Tangxia Hospital and Guangdong Medical College Affiliated Hospital of Dongguan City from August 2013 to August 2014 were selected and randomly divided into two groups according to the number of randomization: 50 in the treatment group and 50 in the control group example. The two groups were given basic treatment, the control group plus phentolamine 10 mg / d slow intravenous infusion of 0.05 mg / min, 1 / d; on the basis of the treatment group fasudil hydrochloride 30 mg dissolved in 0.9 % Sodium chloride injection 100 m L, intravenous infusion, 2 times / d. Both groups were treated for 14 days. Plasma N-BNP and D-dimer levels and pulmonary artery systolic pressure were measured before and after treatment in both groups. Results: Before treatment, there was no significant difference between the two groups (P> 0.05). After 14 days of treatment, the levels of plasma N-BNP, D-dimer and pulmonary artery systolic pressure in both groups were significantly higher than those before treatment (P <0.05). However, the decline in the treatment group was more significant (P <0.05). No adverse reactions were observed in the treatment group with Fasudil. CONCLUSION: Fasudil is effective and safe in the treatment of chronic obstructive pulmonary disease and pulmonary hypertension. Its mechanism may be to reduce pulmonary hypertension and improve cardiopulmonary function by decreasing plasma levels of N-BNP and D-dimer.