摘要
目的探讨阿托伐他汀联合曲美他嗪对慢性心力衰竭(CHF)患者心功能及细胞因子的影响。方法将97例慢性心力衰竭患者随机分为对照组、阿托伐他汀组和联合治疗组,对照组行常规抗心衰治疗,阿托伐他汀组在常规抗心衰治疗的基础上加用阿托伐他汀,联合治疗组在常规抗心衰治疗的基础上加用阿托伐他汀及曲美他嗪。所有患者在治疗前及治疗6个月后检测血清C反应蛋白(CRP)、血浆脑利钠肽(BNP)、肿瘤坏死因子-α(TNF-α)水平,超声心动图检测左室射血分数(LVEF)和左室内径(LVEDD)。结果心功能Ⅳ级的患者与心功能≤Ⅲ级的患者相比,CRP、BNP及TNF-α水平均显著升高(均P<0.05)。与治疗前相比,各组治疗后CRP、BNP及TNF-α水平显著下降,LVEF、LVEDD明显改善(P<0.05或P<0.01),阿托伐他汀组及联合治疗组CRP、BNP及TNF-α水平下降较对照组更为显著(均P<0.05),LVEF、LVEDD改善较对照组明显,6分钟步行试验行走距离显著延长(P<0.05)。与阿托伐他汀组相比,联合治疗组治疗后CRP、BNP及TNF-α水平差异及LVEF、LVEDD变化无统计学意义,但6分钟步行试验行走距离显著延长(P<0.05)。结论在常规治疗的基础上加用阿托伐他汀可进一步降低心力衰竭患者血液中CRP、BNP及TNF-α水平,发挥抗炎作用,同时改善患者心功能,阿托伐他汀联合曲美他嗪治疗降低心衰患者心肌耗氧,提高了患者的运动耐量。
Objective To investigate the effect of atovastatin combined with trimetazidine on cardiac function and inflammatory cytokines in patients with chronic heart failure（CHF）.Methods Ninety-seven patients with CHF were randomly divided into three groups：control group treated with conventional therapy,atovastatin group treated with atovastatin based on conventional therapy,and combined treatment group treated with atovastatin and trimetazidine based on conventional therapy.The parameters of cardiac function,including left ventricular ejection fraction（LVEF）and left ventficular end-diastolic diameter（LVEDD）,and the plasma levels of CRP,brain natriuretic peptide（BNP）,and TNF-α were detected in all patients of each group before and after treatment.Results The plasma levels of CRP,BNP and TNF-α in patients with cardiac function Ⅳ were significantly higher than in those with cardiac function ≤Ⅲ（P〈0.05）.There was significant difference in plasma levels of CRP,BNP,TNF-α,LVEF and LVEDD before and after treatment in all groups（P〈0.05 or P〈0.01）.As compared with control group after treatment,the plasma levels of CRP,BNP and TNF-α after treatment in both atovastatin group and combined treatment group were decreased markedly（P〈0.05）,so did LVEF,LVEDD and 6-min walk test（P〈0.05）.There was no significant difference in changes of CRP,BNP and TNF-α plasma levels,LVEF and LVEDD between atovastatin group and combined group after treatment（P〉0.05）,but 6-min walk test lengthened statistically in combined treatment group（P〈0.05）.Conclusion Atovastatin based on conventional therapy may play a role in anti-inflammation by lowering the plasma levels of CRP,BNP and TNF-α in patients with CHF,thereby improving cardiac function.Atovastatin combined with tremetazidine could reduce the cardiac muscular oxygen consumption and raise the excise endurance in patients with CHF.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2009年第5期689-691,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
慢性心力衰竭
阿托伐他汀
曲美他嗪
炎症因子
chronic heart failure
atovastatin
tremetazidine
inflammatory cytokines
