海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2015年
4期
486-489
,共4页
郭寿贵%郭佳茹%许惠莲%吴少英
郭壽貴%郭佳茹%許惠蓮%吳少英
곽수귀%곽가여%허혜련%오소영
阿托伐他汀%冠心病%慢性心力衰竭%心房纤颤%预后
阿託伐他汀%冠心病%慢性心力衰竭%心房纖顫%預後
아탁벌타정%관심병%만성심력쇠갈%심방섬전%예후
Atorvastatin%Coronary heart disease%Chronic heart failure%Atrial fibrillation%Prognosis
目的：研究阿托伐他汀治疗对冠心病并慢性心力衰竭(CHF)及心房纤颤(AF)患者的影响。方法62例冠心病并CHF及AF住院患者随机分成两组，他汀组32例，非他汀组30例，两组患者均常规抗心衰等治疗，而他汀组加用阿托伐他汀(立普妥)20 mg/d，分别随访1年，观察两组出院后不同类型房颤的复发及维持情况，评估随访1年内主要不良心血管事件(心血管死亡、非致死性心肌梗死及卒中)风险及心衰再住院率。结果治疗前两组在性别、年龄、并存疾病、AF类型、NYHA心功能分级、左室射血分数(LVEF)、左房内径(LAD)左室舒张末期内径(LVEDD)方面比较差异均无统计学意义(P>0.05)。随访期间主要心血管不良事件发生率他汀组和非他汀组比较差异无统计学意义(31.3%vs 53.3%，χ2=3.817，P=0.282)；而他汀组的心衰再住院率减低(25.0%vs 50.0%，P=0.042)；阵发性AF复发率他汀组较之非他汀组降低(28.1%vs 53.3%，P=0.043)；但持续性房颤复发率两者差异无统计学意义(18.8%vs 20.0%，P=0.901)。结论阿托伐他汀可减少冠心病并CHF及AF患者的阵发性AF复发、降低心衰再住院率，但对主要心血管不良事件发生率无明显影响。
目的：研究阿託伐他汀治療對冠心病併慢性心力衰竭(CHF)及心房纖顫(AF)患者的影響。方法62例冠心病併CHF及AF住院患者隨機分成兩組，他汀組32例，非他汀組30例，兩組患者均常規抗心衰等治療，而他汀組加用阿託伐他汀(立普妥)20 mg/d，分彆隨訪1年，觀察兩組齣院後不同類型房顫的複髮及維持情況，評估隨訪1年內主要不良心血管事件(心血管死亡、非緻死性心肌梗死及卒中)風險及心衰再住院率。結果治療前兩組在性彆、年齡、併存疾病、AF類型、NYHA心功能分級、左室射血分數(LVEF)、左房內徑(LAD)左室舒張末期內徑(LVEDD)方麵比較差異均無統計學意義(P>0.05)。隨訪期間主要心血管不良事件髮生率他汀組和非他汀組比較差異無統計學意義(31.3%vs 53.3%，χ2=3.817，P=0.282)；而他汀組的心衰再住院率減低(25.0%vs 50.0%，P=0.042)；陣髮性AF複髮率他汀組較之非他汀組降低(28.1%vs 53.3%，P=0.043)；但持續性房顫複髮率兩者差異無統計學意義(18.8%vs 20.0%，P=0.901)。結論阿託伐他汀可減少冠心病併CHF及AF患者的陣髮性AF複髮、降低心衰再住院率，但對主要心血管不良事件髮生率無明顯影響。
목적：연구아탁벌타정치료대관심병병만성심력쇠갈(CHF)급심방섬전(AF)환자적영향。방법62례관심병병CHF급AF주원환자수궤분성량조，타정조32례，비타정조30례，량조환자균상규항심쇠등치료，이타정조가용아탁벌타정(립보타)20 mg/d，분별수방1년，관찰량조출원후불동류형방전적복발급유지정황，평고수방1년내주요불양심혈관사건(심혈관사망、비치사성심기경사급졸중)풍험급심쇠재주원솔。결과치료전량조재성별、년령、병존질병、AF류형、NYHA심공능분급、좌실사혈분수(LVEF)、좌방내경(LAD)좌실서장말기내경(LVEDD)방면비교차이균무통계학의의(P>0.05)。수방기간주요심혈관불량사건발생솔타정조화비타정조비교차이무통계학의의(31.3%vs 53.3%，χ2=3.817，P=0.282)；이타정조적심쇠재주원솔감저(25.0%vs 50.0%，P=0.042)；진발성AF복발솔타정조교지비타정조강저(28.1%vs 53.3%，P=0.043)；단지속성방전복발솔량자차이무통계학의의(18.8%vs 20.0%，P=0.901)。결론아탁벌타정가감소관심병병CHF급AF환자적진발성AF복발、강저심쇠재주원솔，단대주요심혈관불량사건발생솔무명현영향。
Objective To study the effects of the atorvastain on the prognosis in patients with coronary heart disease (CHD) complicated with chronic heart failure (CHF) and atrial fibrillation (AF). Methods Sixty-two consec- utive patients admitted for CHD complicated with CHF and AF were divided randomly into two groups: the statin group and the no-statin group. Patients of the both groups were treated with conventional medication of anti-heart failure, and patients in the statin group received additional atorvastatin 20 mg daily. Both groups were followed up for about one year. The recurrence and maintenance of different types of AF were observed after discharge. The risk of the major adverse cardiovascular events (MACE), including cardiovascular mortality, nonfatal myocardial infarction and stroke, and the rates of re-hospitalization for worsening heart failure were evaluated during 1-year follow-up. Results There were no signifi-cant differences between the two groups in gender, age, comorbidities such as hypertension and diabetes mellitus, the types of AF, NYHA cardiac functional grading, left ventricular ejection fraction (LVEF), left atrial dimension (LAD) and left ventricular end-diastolic dimension (LVEDD). The incidence of MACE during follow-up between the statin and the no-statin groups was of no significant difference (31.3%vs 53.3%,χ2=3.817, P=0.282). However, the readmis-sions rate for worsening HF in the statin group was significantly lower (25.0%vs 50.0%, P=0.042). The recurrence rate of paroxysmal AF was lower in the statin group compared with the no-statin group (28% vs 53%, P=0.043), whereas there was no significant difference of persistent AF between the two groups (18.8% vs 20.0%, P=0.901). Conclusion Atorvastatin could reduce the incidence of recurrent paroxysmal AF and the readmission rate for HF in patients with CHD complicated with CHF and AF, whereas it had no significant effect on the incidence of MACE.
