摘要
目的 :观察阿托伐他汀对扩张型心肌病 (DCM )患者心功能及心率变异性的影响。方法 :选择 4 5例DCM患者 ,随机分为常规治疗组 (2 2例 )及阿托伐他汀治疗组 (2 3例 ) ,后者在常规治疗基础上合用阿托伐他汀10mg/d ,疗程 12周。采用心脏彩色多普勒超声测定左室射血分数 (LVEF)、左室收缩末期容量指数 ,动态心电图测定心率变异性 ,同时测定血浆丙二醛、一氧化氮 (NO)、肿瘤坏死因子 (TNF α)、白细胞介素 6 (IL 6 )及基质金属蛋白酶 9(MMP 9)。结果 :阿托伐他汀使血浆丙二醛、TNF α、IL 6及MMP 9明显降低 ,NO增加 (P <0 .0 1) ,LVEF增加、左室收缩末期容量指数降低 (P <0 .0 5 ) ,正常R R间期标准差 (SDNN)、低频成分增加 (P <0 .0 1)。LVEF增加与NO增加不相关 (r =0 .2 7,P >0 .0 5 ) ,与丙二醛、TNF α、IL 6及MMP 9降低呈负相关 (r =- 0 .4 0 ,- 0 .4 6 ,- 0 .4 8,- 0 .4 3,P <0 .0 5 )。SDNN增加与LVEF增加呈正相关 (r =0 .5 7,P <0 .0 1) ,与左室收缩末期容量指数降低呈负相关 (r =- 0 .5 8,P <0 .0 1)。结论 :阿托伐他汀改善DCM患者心功能的同时改善心率变异性 ,心功能改善可能与抗氧化及抗炎有关。
Objective:To observe the effect of atorvastatin on cardiac function and heart rate variability in patients with idiopathic dilated cardiomyopathy (DCM).Method:Forty-five patients with DCM were divided into two groups patients in, one group (n=23)received atorvastatin 10 mg/d plus routine theraphy, and in the other,(n=22) received routine theraphy only. At the beginning of therapy and 12 weeks later, in addition to, plasma malondialdehyde, nitric oxide, tumor necrosis factor-α(TNF-α), interleukin-6 and matrix metalloproteinase-9 (MMP-9) level were assayed, left ventricular ejection fraction (LVEF), left ventricular end systolic volume index (LVESVI)were measured by Echo-Doppler, time-and frequency-domain heart rate variability parameters were calculated from 24 h digital holter monitoring.Result:After 12-weeks therapy with atorvastatin, the plasma malondialdehyde, TNF-α, interleukin-6 and matrix metalloproteinase-9 levels decreased, nitric oxide increased (P< 0.01), LVEF increased and LVESVI decreased (P< 0.05). Standard deviation of normal-to-normal intervals(SDNN) and low frequency power (LFP) increased (P< 0.01), △LVEF the increase of LVEF was no relation to that of NO △ nitric oxide (r= 0.27,P> 0.05), while with negative correlative to the decrease of △malondialdehyde, △TNF-α, △ interleukin-6 and △matrix metalloproteinase-9 level (r=- 0.40, - 0.46, - 0.48, - 0.43, respectively, P< 0.05).The increase of △SDNN was positively (r= 0.57, P< 0.01), while negatively correlative to the decrease of △LVESVI (r= - 0.58, P< 0.01). Conclusion:Atorvastatin improves cardiac function as well as heart rate variability in patients with idiopathic dilated cardiomyopathy, which may be led by its anti-inflamma-tory and anti-oxidation effect.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2004年第3期133-135,共3页
Journal of Clinical Cardiology
关键词
心肌病
扩张型
他汀
心脏功能
一氧化氮
Dilated cardiomyopathy
Statin
Cardiac function
Nitric oxide
