中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
28期
21-23
,共3页
心房颤动%C反应蛋白质%阿托伐他汀
心房顫動%C反應蛋白質%阿託伐他汀
심방전동%C반응단백질%아탁벌타정
Atrial fibrillation%C-reactive protein%Atorvastatin
目的 探讨阿托伐他汀对慢性心功能不全合并阵发性心房颤动患者C反应蛋白(CRP)水平以及临床预后的影响.方法 将186例慢性心功能不全合并阵发性心房颤动患者按照随机数字表法分为观察组和对照组,每组93例.对照组给予强心、利尿等常规治疗,观察组在常规治疗的基础上给予阿托伐他汀20 mg,1次/晚,连续1年.观察比较两组治疗前后血脂水平、左心房内径、左心室射血分数(LVEF)、CRP水平和临床预后.结果 对照组治疗前后血脂水平比较差异无统计学意义(P＞0.05)；观察组治疗后总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平降低[(4.1±0.6) mmol/L比(4.8±0.6) mmol/L、(2.7±0.3) mmol/L比(3.5±0.5) mmol/L],高密度脂蛋白胆固醇(HDL-C)水平升高[(1.0±0.1)mmol/L比(0.9±0.1)mmol/L],差异有统计学意义(P＜0.05),且与同期对照组比较差异亦有统计学意义(P＜0.05).两组左心房内径、LVEF治疗前后组内、组间比较差异均无统计学意义(P＞0.05).治疗前和治疗后1、6个月观察组CRP水平分别为(15.2±3.8)、(12.1±2.7)、(9.9±2.8)mg/L,对照组分别为(15.0±3.8)、(14.0±2.9)、(13.7±2.8) mg/L,两组治疗前比较差异无统计学意义(P＞0.05),治疗后1、6个月观察组均显著低于对照组(P＜0.05).观察组心房颤动再次发作率、转化为持续性或永久性心房颤动率明显低于对照组[6.5％(6/93)比21.5％(20/93),6.5％ (6/93)比19.4％( 18/93)],差异有统计学意义(P＜0.05).结论 阿托伐他汀能降低慢性心功能不全合并阵发性心房颤动患者的CRP水平,减少和减缓阵发性心房颤动的再发和进展.
目的 探討阿託伐他汀對慢性心功能不全閤併陣髮性心房顫動患者C反應蛋白(CRP)水平以及臨床預後的影響.方法 將186例慢性心功能不全閤併陣髮性心房顫動患者按照隨機數字錶法分為觀察組和對照組,每組93例.對照組給予彊心、利尿等常規治療,觀察組在常規治療的基礎上給予阿託伐他汀20 mg,1次/晚,連續1年.觀察比較兩組治療前後血脂水平、左心房內徑、左心室射血分數(LVEF)、CRP水平和臨床預後.結果 對照組治療前後血脂水平比較差異無統計學意義(P＞0.05)；觀察組治療後總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)水平降低[(4.1±0.6) mmol/L比(4.8±0.6) mmol/L、(2.7±0.3) mmol/L比(3.5±0.5) mmol/L],高密度脂蛋白膽固醇(HDL-C)水平升高[(1.0±0.1)mmol/L比(0.9±0.1)mmol/L],差異有統計學意義(P＜0.05),且與同期對照組比較差異亦有統計學意義(P＜0.05).兩組左心房內徑、LVEF治療前後組內、組間比較差異均無統計學意義(P＞0.05).治療前和治療後1、6箇月觀察組CRP水平分彆為(15.2±3.8)、(12.1±2.7)、(9.9±2.8)mg/L,對照組分彆為(15.0±3.8)、(14.0±2.9)、(13.7±2.8) mg/L,兩組治療前比較差異無統計學意義(P＞0.05),治療後1、6箇月觀察組均顯著低于對照組(P＜0.05).觀察組心房顫動再次髮作率、轉化為持續性或永久性心房顫動率明顯低于對照組[6.5％(6/93)比21.5％(20/93),6.5％ (6/93)比19.4％( 18/93)],差異有統計學意義(P＜0.05).結論 阿託伐他汀能降低慢性心功能不全閤併陣髮性心房顫動患者的CRP水平,減少和減緩陣髮性心房顫動的再髮和進展.
목적 탐토아탁벌타정대만성심공능불전합병진발성심방전동환자C반응단백(CRP)수평이급림상예후적영향.방법 장186례만성심공능불전합병진발성심방전동환자안조수궤수자표법분위관찰조화대조조,매조93례.대조조급여강심、이뇨등상규치료,관찰조재상규치료적기출상급여아탁벌타정20 mg,1차/만,련속1년.관찰비교량조치료전후혈지수평、좌심방내경、좌심실사혈분수(LVEF)、CRP수평화림상예후.결과 대조조치료전후혈지수평비교차이무통계학의의(P＞0.05)；관찰조치료후총담고순(TC)、저밀도지단백담고순(LDL-C)수평강저[(4.1±0.6) mmol/L비(4.8±0.6) mmol/L、(2.7±0.3) mmol/L비(3.5±0.5) mmol/L],고밀도지단백담고순(HDL-C)수평승고[(1.0±0.1)mmol/L비(0.9±0.1)mmol/L],차이유통계학의의(P＜0.05),차여동기대조조비교차이역유통계학의의(P＜0.05).량조좌심방내경、LVEF치료전후조내、조간비교차이균무통계학의의(P＞0.05).치료전화치료후1、6개월관찰조CRP수평분별위(15.2±3.8)、(12.1±2.7)、(9.9±2.8)mg/L,대조조분별위(15.0±3.8)、(14.0±2.9)、(13.7±2.8) mg/L,량조치료전비교차이무통계학의의(P＞0.05),치료후1、6개월관찰조균현저저우대조조(P＜0.05).관찰조심방전동재차발작솔、전화위지속성혹영구성심방전동솔명현저우대조조[6.5％(6/93)비21.5％(20/93),6.5％ (6/93)비19.4％( 18/93)],차이유통계학의의(P＜0.05).결론 아탁벌타정능강저만성심공능불전합병진발성심방전동환자적CRP수평,감소화감완진발성심방전동적재발화진전.
Objective To investigate the influence of atorvastatin on C-reactive protein (CRP) level and clinical prognosis for chronic cardiac insufficiency combined with paroxysmal atrial fibrillation patients.Methods One hundred and eight-six chronic cardiac insufficiency combined with paroxysmal atrial fibrillation patients were divided into observation group (93 cases) and control group (93 cases) by random number table.The control group was given conventional treatment such as cardiotonic and diuretic,while the observation group was given atorvastatin 20 mg one time/night for 1 year on the basis of conventional treatment.Before and after treatment,lipid,left atrial diameter,left ventricular ejection fraction (LVEF),CRP and clinical outcome were compared.Results Lipid levels of the control group were not significantly different before and after treatment (P ＞ 0.05 ).In observation group,the levels of total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C) and highdensity lipoprotein-cholesterol (HDL-C) after treatment were improved compared with those before treatment [ (4.1 ± 0.6) mmol/L vs.(4.8 ± 0.6) mmol/L,(2.7 ±0.3) mmol/L vs. (3.5 ±0.5) mmol/L,(1.0 ±0.1) mmol/L vs. (0.9 ±0.1) mmol/L,P ＜0.05].After treatment,the levels of TC,LDL-C and HDL-C in observation group were improved compared with those in control group (P＜ 0.05 ).There was no significant difference in left atrial diameter and LVEF before and after treatment in two groups.The levels of CRP before and 1 month and 6 months after treatment were ( 15.2 ±3.8),(12.1 ±2.7),(9.9 ±2.8) mg/L in observation group,and (15.0 ±3.8),(14.0 ±2.9),(13.7 ±2.8)mg/L in control group,and there were significant differences between two groups 1 month and 6 months after treatment (P ＜ 0.05).The incidences of atrial fibrillation recurrence and conversion for persistent or permanent atrial fibrillation in observation group were significantly lower than those in control group [6.5％ (6/93) vs.21.5％ (20/93),6.5％ (6/93) vs.19.4％ ( 18/93 ),P ＜ 0.05 ].Conclusion Atorvastatin can reduce CRP level of chronic cardiac insufficiency combined with paroxysmal atrial fibrillation patients,and reduce and delay recurrence and progress of paroxysmal atrial fibrillation.
