辛伐他汀对慢性心力衰竭患者左室收缩功能及血浆脑钠肽水平变化的研究

Changes of left ventricular function and plasma level of brain netriuretic petide in chronic heart failure patients on simvastatin

目的观察辛伐他汀对慢性心力衰竭(CHF)患者左室收缩功能及血浆脑钠肽(BNP)的变化。方法经超声心动图检查,测出64例慢性心力衰竭患者以及20例健康对照者的左室舒张末内径(LVEDd)、左室射血分数(LVEF)及左室短轴缩短率(LVFS),应用酶联免疫吸附法(ELISA)测定两组脑钠肽(BNP)的浓度;将心衰患者随即分为30例常规治疗组和34例加用辛伐他汀组,1个月和6个月时再测定上述指标。结果心衰患者在治疗1个月LVEDd、LVEF及LVFS与治疗前比较均无统计学差异(P>0.05),6个月时的上述指标与治疗前比较差异有显著性(P<0.01),辛伐他汀组LVEF较常规治疗组LVEF升高更明显(P<0.05)。心衰患者在治疗前血浆BNP水平均高于正常对照组,治疗1个月和6个月血浆BNP水平均明显下降,但辛伐他汀组与常规治疗组同期比较下降更明显(P<0.05)。两组患者血浆BNP水平与LVEF呈负相关(P<0.01)。结论长期应用辛伐他汀可以改善慢性心力衰竭患者心功能和降低血浆BNP水平;慢性心力衰竭患者血浆BNP水平的改变早于心脏结构的变化,血浆BNP水平可作为治疗慢性心力衰竭的一个灵敏观察指标。

[Objective] To observe the change of left ventricular function and plasma level of brain netrinretic petide（BNP）in chronic heart failure patients on simvastatin.[Methods] 64 patients with chronic heart failure group and 20 healthy controls were examined by echocardiography and their plasma concentrations of BNP were measured by enzyme linked immunosorbent assay（ELISA）.The heart failure group was further subdivided into conventional and plus simvastatin groups.The parameters were re-checked one month and six months later.[Results] The constructive and functional parameter（LVEF）improved significantly only after six month treatment,the plasma BNP level decreased signifivantly after 1-or-6 month treatment（P 〈0.01）.The decreased level of these parameters were greater in simvastatin-treatment group than in conventional group（P 〈0.05）.The plasma BNP in heart failure patients were apparently higher than those of healthy subjects（P 〈0.01）and negatively correlated with LVEF（P 〈0.01）.[Conclusion] The long-term treatmen of simvastatin may improve cardic function and decrease the plasma BNP.The changes of BNP develops earlier than that of constructive and functional parameters and can be used as a sensitive index for simvastatin treatment of chronic heart failure.