充血性心力衰竭患者血清C-反应蛋白水平及立普妥的干预作用

The levels of serum c-reactive protein in patients with congestive heart failure and the effects of Lipitor

目的研究充血性心力衰竭（CHF）患者血清中C-反应蛋白（CRP）水平及与心功能的关系,并观察立普妥对CRP的影响。方法入选66例CHF患者（NYHAⅡ～Ⅳ级）,30例正常对照者;应用免疫比浊法测定血清CRP水平,采用超声心动图测量左心室射血分数（LVEF）。次日晨检测血清CRP,3d内行超声心动图检查。CHF组随机分为立普妥组、常规治疗组,所有CHF患者均给予常规治疗,立普妥组加服立普妥10mg/d,8周后复查血清CRP。结果CHF组较正常对照组血清CRP水平明显增高（P〈0.01）,并且随NYHA心功能级别增高,血清CRP水平明显升高（P〈0.01）。血清CRP浓度与LVEF呈负相关（r=-0.571,P〈0.01）。CHF患者经治疗,立普妥组血清CRP水平的下降比常规治疗组更为显著（P〈0.01）。结论①心力衰竭患者血清CRP水平增高,并且心力衰竭越重,CRP水平越高,血清CRP水平和左心室射血分数呈负相关;②立普妥能降低CHF患者的CRP水平。

Objective To investigate the levels of serum C-reactive protein（CRP） and the relationship of CRP with cardiac function in patients with congestive heart failure （ CHF ）, and to observe the effects of Lipitor on CRP. Methods 66 patients with CHF （classified as NYHA Ⅱ～Ⅳ grade） and 30 healthy subjects （control group） were involved in the study. The level of serum CRP was measured by immunoturbidimetry in the next morning and left ventrieular ejection fraction （ LVEF） was determined with ultrasonic cardiogram in three days. CHF group was randomly divided into Lipitor group and conventional therapy group. All patients with CHF were given conventional therapy. The Lipitor group was added Lipitor 10 mg/d. Serum level of CRP was rechecked after 8 weeks treatment. Results Serum level of CRP in CHF group is significantly higher than control group （ P 〈 0.01 ）. The higher rank of NYHA cardiac function classification, the higher the level of CRP （ P 〈 0.01 ）. Serum level of CRP was negatively correlated with LVEF（ r = -0. 571, P 〈 0.01 ）. After treatment, the dropping of CRP is more significant in Lipitor group than in conventional therapy group （ P 〈 0.01 ）. Conclusion ①CRP is increased in heart failure patients. Higher levels of CRP are associated with features of more severe heart failure. The serum level of CRP is negatively correlated with LVEF.②Lipitor can decrease the level of CRP in patients with CHF.