普伐他汀对扩张型心肌病患者心功能及细胞因子的影响

Effect of pravastatin on cardiac function and cytokines in patients with dilated cardiomyopathy

目的观察普伐他汀对扩张型心肌病(DCM)心力衰竭患者心功能及血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平的影响。方法选择DCM心力衰竭患者68例,随机分为治疗组(35例)及对照组(33例)。对照组给予常规纠正心力衰竭药物治疗,治疗组在常规治疗基础上加用普伐他汀,10mg,每晚一次。治疗前及后6个月后行心脏彩超检查,测定左心室舒张末内径(LVEDd)、左心室射血分数(LVEF),测定血清TNF-α、IL-6浓度。结果两组患者治疗6个月时LVEDd均较治疗前显著缩小(P<0.05),LVEF较治疗前显著提高(P<0.05)。治疗6个月时治疗组与对照组比较:LVEF较对照组显著提高(P<0.05),LVEDd有进一步缩小趋势,但差异无统计学意义。治疗6个月时,治疗组血清TNF-α(146.26±1.27和174.58±1.42,P<0.05)、IL-6(25.56±1.79和35.23±1.87,P<0.05)水平较治疗前显著下降,对照组较治疗前无明显变化。结论普伐他汀可明显改善DCM心力衰竭患者心功能,降低血清TNF-α、IL-6水平,有利于DCM的治疗。

Objective To investigate the effect of Pravastatin on cardiac function and serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in patients with dilated cardiomyopathy （DCM）.Methods Sixty-eight patients with DCM were randomly divided into two groups： pravastatin group （n=35） and conventional therapy group （n=33） .All patients were treated by conventional therapy. The pravastatin group plus pravastatin 10mg, quaque nocte for 6 months.Before and after treatment, the left ventricular ejection fraction（ LVEF）,left ventricular end-diastolic diameter （LVEDd） were measured by ultrasonic cardiography and serum lipids,TNF-α and IL-6 were measured by radioimmunoassay.Results After six months ,the LVEDd were significantly lower and LVEF was dramatically higher in all patients （P〈0.05）,the LVEF in pravastatin group were significantly higher than that in the conventional therapy group（P〈0.05） .The serum level of TNF-α（ 174.58±1.42 vs 146.26±1.27,P〈 0.05）and IL-6 （35.23±1.87 vs 25.56±1.79,P〈0.05） were significantly lower in pravastatin group. Conclusion Pravastatin can improve cardiac function and decrease serum levels of TNF-α and IL-6 in Patients with dilated cardiomyopathy.