华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
ACTA UNIVERSITATIS MEDICINAE TONGJI
2009年
5期
689-691
,共3页
慢性心力衰竭%阿托伐他汀%曲美他嗪%炎症因子
慢性心力衰竭%阿託伐他汀%麯美他嗪%炎癥因子
만성심력쇠갈%아탁벌타정%곡미타진%염증인자
chronic heart failure%atovastatin%tremetazidine%inflammatory cytokines
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.
目的 探討阿託伐他汀聯閤麯美他嗪對慢性心力衰竭(CHF)患者心功能及細胞因子的影響.方法 將97例慢性心力衰竭患者隨機分為對照組、阿託伐他汀組和聯閤治療組,對照組行常規抗心衰治療,阿託伐他汀組在常規抗心衰治療的基礎上加用阿託伐他汀,聯閤治療組在常規抗心衰治療的基礎上加用阿託伐他汀及麯美他嗪.所有患者在治療前及治療6箇月後檢測血清C反應蛋白(CRP)、血漿腦利鈉肽(BNP)、腫瘤壞死因子-α(TNF-α)水平,超聲心動圖檢測左室射血分數(LVEF)和左室內徑(LVEDD).結果 心功能Ⅳ級的患者與心功能≤Ⅲ級的患者相比,CRP、BNP及TNF-α水平均顯著升高(均P<0.05).與治療前相比,各組治療後CRP、BNP及TNF-α水平顯著下降,LVEF、LVEDD明顯改善(P<0..05或P<0.01),阿託伐他汀組及聯閤治療組CRP、BNP及TNF-α水平下降較對照組更為顯著(均P<0.05),LVEF、LVEDD改善較對照組明顯,6分鐘步行試驗行走距離顯著延長(P<0.05).與阿託伐他汀組相比,聯閤治療組治療後CRP、BNP及TNF-α水平差異及LVEF、LVEDD變化無統計學意義,但6分鐘步行試驗行走距離顯著延長(P<0.05).結論 在常規治療的基礎上加用阿託伐他汀可進一步降低心力衰竭患者血液中CRP、BNP及TNF-α水平,髮揮抗炎作用,同時改善患者心功能,阿託伐他汀聯閤麯美他嗪治療降低心衰患者心肌耗氧,提高瞭患者的運動耐量.
목적 탐토아탁벌타정연합곡미타진대만성심력쇠갈(CHF)환자심공능급세포인자적영향.방법 장97례만성심력쇠갈환자수궤분위대조조、아탁벌타정조화연합치료조,대조조행상규항심쇠치료,아탁벌타정조재상규항심쇠치료적기출상가용아탁벌타정,연합치료조재상규항심쇠치료적기출상가용아탁벌타정급곡미타진.소유환자재치료전급치료6개월후검측혈청C반응단백(CRP)、혈장뇌리납태(BNP)、종류배사인자-α(TNF-α)수평,초성심동도검측좌실사혈분수(LVEF)화좌실내경(LVEDD).결과 심공능Ⅳ급적환자여심공능≤Ⅲ급적환자상비,CRP、BNP급TNF-α수평균현저승고(균P<0.05).여치료전상비,각조치료후CRP、BNP급TNF-α수평현저하강,LVEF、LVEDD명현개선(P<0..05혹P<0.01),아탁벌타정조급연합치료조CRP、BNP급TNF-α수평하강교대조조경위현저(균P<0.05),LVEF、LVEDD개선교대조조명현,6분종보행시험행주거리현저연장(P<0.05).여아탁벌타정조상비,연합치료조치료후CRP、BNP급TNF-α수평차이급LVEF、LVEDD변화무통계학의의,단6분종보행시험행주거리현저연장(P<0.05).결론 재상규치료적기출상가용아탁벌타정가진일보강저심력쇠갈환자혈액중CRP、BNP급TNF-α수평,발휘항염작용,동시개선환자심공능,아탁벌타정연합곡미타진치료강저심쇠환자심기모양,제고료환자적운동내량.
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.
