阿托伐他汀钙联合美托洛尔治疗慢性充血性心力衰竭的临床观察

Clinical Observation of Atorvastatin Calcium Combined with Metoprolol in the Treatment of Chronic Congestive Heart Failure

目的：观察阿托伐他汀钙联合美托洛尔治疗慢性充血性心力衰竭（CHF）的疗效和安全性。方法：207例CHF患者随机分为对照组（102例）和观察组（105例）。对照组患者给予强心、利尿、扩血管和吸氧等治疗,同时口服酒石酸美托洛尔片,起始剂量6.25 mg,每日2~3次,视病情改善情况增加6.25～12.5 mg,每日2～3次;观察组患者在对照组治疗的基础上给予阿托伐他汀钙片80 mg,口服,每日2次。两组疗程均为16周。观察两组患者的临床疗效,治疗前后心功能指标[左心室射血分数（LVEF）、左室收缩末期内径（LVESD）、二尖瓣舒张早期与舒张晚期血流峰值速度比值（E/A）]、血脂{脂蛋白（a）[Lp（a）]、三酰甘油（TG）、总胆固醇（TC）}水平及不良反应发生情况。结果：观察组患者总有效率显著高于对照组,差异有统计学意义（P〈0.05）。治疗前,两组患者心功能指标、血脂水平比较,差异均无统计学意义（P〉0.05）;治疗后,两组患者LVEF、E/A均显著高于同组治疗前,且观察组高于对照组,LVESD、Lp（a）、TG、TC均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义（P〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论：在常规治疗的基础上,阿托伐他汀钙联合美托洛尔治疗CHF的疗效显著优于单用美托洛尔,且安全性相当。

OBJECTIVE：To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure（CHF）. METHODS：207 CHF patients were randomly divided into control group（102 cases）and observation group（105 cases）. Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tartrate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day.Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w.Clinical efficacy,cardiac functions [left ventricular ejection fraction（LVEF）,left ventricular end systolic diameter（LVESD）,mitral early diastolic and late diastolic peak flow velocity ratio（E/A）],blood lipids [lipoprotein（a）Lp（a）,triglyceride（TG）,total cholesterol（TC）] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS：The total effective rate in observation group was significantly higher than control group,the difference was statistically significant（P〉0.05）. Before treatment,there were no significant differences in cardiac functions and blood lipids in 2 groups（P〉0.05）. After treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp（a）,TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant（P〈0.05）. And there was no significant difference in the incidence of adverse reactions（P〉0.05）. CONCLUSIONS：Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is superior to metoprolol in the treatment of CHF,with better safety.