心脏舒张功能障碍逆转的临床探讨

目的：探讨心脏舒张功能障碍的逆转。方法：入选我院舒张功能障碍的病人223例,随机分为常规治疗组,给予丹参滴注液16g,1次/d;磷酸肌酸钠组：在常规治疗组基础上给予磷酸肌酸钠静脉滴注（轻度舒张功能障碍每日给药2.0g,中重度舒张功能障碍给药2.0g,2次/d）,并采用彩色多普勒超声心动图观察二尖瓣口舒张早期峰值流速（E）、二尖瓣口舒张晚期峰值流速（A）、二尖瓣环舒张早期速度峰值（Ea）、二尖瓣环舒张晚期速度峰值（Aa）,计算E/A值,Ea/Aa值,E/Ea值。连续治疗14d,并根据治疗前后临床症状、体征及彩色多普勒超声心动图各指标改善情况评价疗效。结果：治疗后,与常规治疗组比较,磷酸肌酸钠组患者的症状、体征显效率（53.8%比98.2%,62.5%比92.0%）,综合疗效的显效率（11.43%比82.97%）,E/A值（0.82±0.15）比（1.20±0.24）]、Ea/Aa值（0.88±0.23）比（1.56±0.31）]显著提高,E/Ea值（9.89±3.15）比（5.84±2.12）]显著降低,P均〈0.01。结论：舒张功能障碍早期发现和干预是可以逆转的,磷酸肌酸钠有显著的治疗作用,是逆转舒张功能障碍的首选药物。

Study for reversal of cardiac diastolic dysfunction

Objective: To study the reversal of cardiac diastolic dysfunction.Methods: A total of 223 patients with diastolic dysfunction were enrolled and randomly divided into routine treatment group(received Salvia miltiorrhiza drip infusion 16g,once a day) and creatine phosphate sodium(CP) group.Patients in CP group received CP intraveinous drip based on routine treatment(those with mild diastolic dysfunction received CP 2.0g,once a day;those with moderate or severe diastolic dysfunction received CP 2.0g,twice a day)].Color-coded Doppler echocardiography was used to measure transmitral early diastolic peak flow velocity(E),transmitral late diastolic peak flow velocity(A),early diastolic peak velocity of mitral annulus(Ea),late diastolic peak velocity of mitral annulus(Aa),and E/A,Ea/Aa,E/Ea were calculated.All patients were treated for 14 d and therapeutic effects were evaluated according to improvements of clinical symptoms,signs and indicators in color-coded Doppler echocardiography after treatment.Results: Compared with routine treatment group after treatment,there were significantly increase in excellence rates of clinical symptom(53.8% vs.98.2%),sign(62.5% vs.92.0%),synthetic curative effect(11.43% vs.82.97%)and E/A ratio (0.82±0.15)vs.(1.20±0.24)]、Ea/Aa (0.88±0.23)vs.(1.56±0.31)],and significantly decrease in E/Ea (9.89±3.15)vs.(5.84±2.12)],P<0.01 all in CP group.Conclusion: If recognized and treated early,diastolic dysfunction is reversible.Creatine phosphate sodium has significant therapeutic effects on diastolic dysfunction and is preferred for reversal of diastolic dysfunction.