Ruan H Y, Zhang Y G, Liu R
Department of Cardiology, the Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou 221009, China.
Zhonghua Yi Xue Za Zhi. 2018 Mar 6;98(9):678-681. doi: 10.3760/cma.j.issn.0376-2491.2018.09.011.
To compare the acute hemodynamic effects of intravenous fasudil with different dosage on patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). Sixty patients (37±17 years old) with CHD and PAH were consecutively enrolled. All patients underwent heart catheterization. The patients were randomly divided into two groups: the regular dosage group and the large dosage group. At initiation and 30 min after intravenous fasudil(30 mg and 60 mg respectively), the following hemodynamic parameters were measured and calculated: right atrial pressure(RAP), pulmonary arterypressure(PAP) , systemic artery pressure (SAP), pulmonary capillary wedge pressure(PCWP) , pulmonary vascular resistance(PVR) and systemic vascular resistance( SVR), cardiac index (CI) and artery oxygen saturation (SaO(2)). Compared with pre-medication, both mPAP and PVR tended to reduce significantly in the regular dosage group and the large dosage group: mPAP from (63.7±8.6)to (58.3±8.5)mmHg(<0.01) and from (62.9±8.8) to(55.1±7.8)mmHg (<0.01), respectively; PVR from(9.9±4.3)to (7.7±3.9) Wood(<0. 01) and from (9.5±4.9)to(6.1±4.8)Wood(<0.01); CI tended to increase significantly in the two groups: from (2.9±0.9) to (3.1±1.1) L·min(-1)·m(-2)( <0.05) and from(3.0±0.8) to (3.5±1.6) L·min(-1)·m(-2)( <0.05), respectively . Compared with the regular dosage group, both mPAP and PVR tended to reduce significantly in the large dosage group: mPAP (8.2±1.8) (4.2±1. 0)mmHg (<0.05); PVR(3.7±1.1) (2.1±0.8 ) Wood (<0.05) .Meanwhile , there was no significant difference in CI, SAP, SVR and SaO(2) between the two groups. Fasudil could improve the acute hemodynamic effects of patients with CHD and severe PAH, especially in the large dosage group.
比较不同剂量静脉注射法舒地尔对先天性心脏病（CHD）合并重度肺动脉高压（PAH）患者的急性血流动力学影响。连续纳入60例年龄为（37±17）岁的CHD合并PAH患者。所有患者均接受了心导管检查。将患者随机分为两组：常规剂量组和大剂量组。在静脉注射法舒地尔（分别为30 mg和60 mg）开始时及30分钟后，测量并计算以下血流动力学参数：右心房压（RAP）、肺动脉压（PAP）、体动脉压（SAP）、肺毛细血管楔压（PCWP）、肺血管阻力（PVR）和体循环血管阻力（SVR）、心脏指数（CI）和动脉血氧饱和度（SaO₂）。与用药前相比，常规剂量组和大剂量组的平均肺动脉压（mPAP）和PVR均显著降低：mPAP分别从（63.7±8.6）降至（58.3±8.5）mmHg（<0.01）和从（62.9±8.8）降至（55.1±7.8）mmHg（<0.01）；PVR分别从（9.9±4.3）降至（7.7±3.9）Wood（<0.01）和从（9.5±4.9）降至（6.1±4.8）Wood（<0.01）；两组的CI均显著升高：分别从（2.9±0.9）升至（3.1±1.1）L·min⁻¹·m⁻²（<0.05）和从（3.0±0.8）升至（3.5±1.6）L·min⁻¹·m⁻²（<0.05）。与常规剂量组相比，大剂量组的mPAP和PVR均显著降低：mPAP（8.2±1.8） （4.2±1.0）mmHg（<0.05）；PVR（3.7±1.1） （2.1±0.8）Wood（<0.05）。同时，两组间的CI、SAP、SVR和SaO₂无显著差异。法舒地尔可改善CHD合并重度PAH患者急性血流动力学效应，尤其是大剂量组。
