他汀类药物对充血性心力衰竭患者心功能及细胞因子的影响

Effect of Statin for Improving Cardiac Function and Cytokines in Patients with Congestive Heart Failure in Early Stage

目的:研究他汀类药物早期应用对慢性心衰患者心功能、细胞因子水平的影响。方法:采用随机、对照研究的方法将68例慢性充血性心衰患者(NYHA分级Ⅱ-Ⅲ级)随机分为他汀类治疗组(n=36)和对照组(n=32)。他汀类药物治疗组应用普伐他汀20mg/d共12周,两研究组治疗前后分别采集空腹静脉血测定血脂水平与细胞因子(IL-6,TNF-α)浓度及超声心动图检查。结果:(1)他汀类药物治疗组治疗12周后,患者LDL-TC水平明显降低(P<0.05),血TNF-α,IL-6水平也有明显降低(P<0.05),对照组治疗前后水平无改善(P>0.05)。(2)他汀类治疗组治疗前后心功能按NYHA分级较对照组有明显改善(P<0.01),超声心动图检查LVEF有显著提高(P<0.05)。结论:他汀类药物早期治疗能降低血脂与细胞因子(TNF-α,IL-6)水平,改善心功能,有益于慢性心衰的生物学治疗策略。

Objective： To study the effects of statin on patients with congestive heart failure in early stage and to investigate the changes of blood levels of tumor necrosis factor alpha （TNF-α） ,interleukin-6 and serum cholesterol level after treatment. Methods： sixty-eight patients with CHF were assigned to statin group （20 mg/d of pravastatin for 12 weeks n=36） or control group （no lipid-lowering drugs were used n=32） in a randomized, doubled-blind ,controlled study. Before and after treatment, the perementers of TNF-α IL-6 and serum cholesterol were measured and analyzed. The heart function was evaluated, too. Results： After 12 weekes, patients receiving pravastatin exhibited a modest reduction in serum cholesterol level compared with control group （P 〈 0.05）. At the same time, New York Heart Association functional class in therapy group was low significant. This corresponded to improved left ventricular ejection fraction in the pravastatin group （P 〈 0.05）. Serum tumor necrosis factor-α,interleukin-6 were significantly lower in the therapy group but control group had not changed. Conclusion： statin improves cardiac function, neurohormonal imbalance, and reduces the level of serum cytokines associated with chronic heart failure in earle stage.