阿托伐他汀对缺血性心肌病患者心功能及血清C-反应蛋白、尿酸水平的影响

Effect of Atorvastatin on Cardiac Function and Plasma C-reactiveprotein and Uric Acid Elevels in Patients Ischemic Cardiomyopathy

目的观察阿托伐他汀对缺血性心肌病患者心功能、血清C-反应蛋白（CRP）、血清尿酸（UA）水平的影响。方法50例缺血性心肌病（NYHA分级Ⅱ～Ⅳ级）随机分成两组，治疗组（25例）和对照组（25例），另选门诊健康查体者20例作为正常组。对照组给予强心、利尿、扩血管治疗，治疗组在此基础上加用阿乐10mg／d，共4周。治疗前后检查心脏超声，评估心功能，测定血CRP、血清UA水平。结果治疗前缺血性心肌病患者的CRP、UA水平较正常组有明显增高（P〈0．01）。心功能Ⅳ级者的CRP、uA浓度较Ⅱ、Ⅲ级者增高明显（P〈0．05）。治疗组血清CRP、UA水平与对照组相比差异均有显著性。治疗组治疗前后左室收缩末期内径、左室舒张末期内径、左室射血分数、心排出量比较差异均有显著性；与对照组治疗后比较差异也有显著性。结论阿托伐他汀能降低血清CRP、UA水平，改善心脏功能，有益于缺血性心肌病的治疗。

Objective To study the effects of atorvastatin on ischemic cardiomyopathy patients with chronic heart failure and to investigate the changes of serum levels of CRP and serum levels of uric acid after treatment. Methods Fifty patients with ischemic cardiomyopathy （NYHAgrade Ⅱ～Ⅳ） were randomly divided into two groups ： the therapy group received atorvastatin lOmg/d （ n = 25 ） for 4 weeks and the control group received placebo（ n = 25）. In addition,20 healthy peoples were observed. Before and after treatment, the parameters of plasma uric acid, serum CRP and cardiac function evaluated by echoeardiogram were measured. Results After 4 weeks, patients receiving atorvastatin exhibited a modest reduction in serum CRP and serum uric acid compared with control group （P〈0.05）. At the same time, the New York Heart Association functional grade in therapy group significantly improved compared with control group （P〈0.05） which was corresponding to the increased left ventricular rejection fraction,left ventricular systolic volume, left ventricular diastolic volume and cardiac output in the atorvastatin group （P〈0.05）. Plasma CRP and uric acid level were also significantly lowered in the therapy group when compared with control group （P〈0.05）. Conclusion Atorvastatin improves cardiac function, reduces levels of plasma CRP and uric acid associated with chronic heart failure.