普伐他汀对缺血性心肌病患者慢性心功能不全的疗效

Effect of pravastatin on chronic cardiac insufficiency in patients with ischemic cardiomyopathy

目的观察常规剂量普伐他汀用于缺血性心肌病(ICM)患者慢性心功能不全治疗的疗效。方法 192例伴慢性心功能不全的ICM患者随机分为治疗组(n=96)和对照组(n=96),对照组接受常规抗心力衰竭治疗,治疗组在对照组基础上加用普伐他汀一日1次20mg(每晚临睡前服用),疗程27周。观察两组患者治疗前后纽约心脏病学会(NYHA)心功能分级、左心室射血分数(LVEF)及氨基末端脑钠肽前体(NT-proBNP)的变化。结果治疗27周治疗组和对照组按NYHA心功能分级评定的总有效率分别为82.3%和67.7%,两组相比,差异有统计学意义(P<0.05);与对照组相比,治疗组LVEF升高[(43.1±11.3)%对(46.4±12.3)%]及NT-proBNP降低[(2711±1020)pg/mL对(2156±926)pg/mL]更显著(P<0.05)。治疗过程中两组均未见严重不良反应发生。结论常规剂量普伐他汀可改善伴慢性心功能不全的缺血性心肌病患者的心功能,且安全性好。

Objective To evaluate the effect of pravastatin on chronic cardiac insufficiency in patients with ischemic cardiomyopathy. Methods Totally 192 patients with ischemic cardiomyopathy complicating chronic cardiac insufficiency were randomly divided into 2 groups. Patients in control group （n=96）were administrated with conventional anti-heart- failure therapy for 27 weeks, and patients in treatment group （n=96） were added to pravastatin on the basis of control group. New York Heart Association （NYHA） functional classification, left ventricular ejection fraction （LVEF） and the level of amino-terminal pro-brain natriuretic peptide （NT-proBNP） were observed before and after treatment. Results After 27-week treatment, the total effective rates of treatment group and control group according to NYHA functional classification were 82.3% and 67.7% respectively. There was significant difference between two groups （P〈0.05）. Compared with control group, the LVEF of treatment group increased significantly （P〈0.05）and the level of NT-proBNP decreased significantly （P〈0.05）. No severe adverse reactions accured in both groups. Conclusion： Conventional pravastatin therapy can improve cardiac function in patients with ischemic cardiomyopathy complicating chronic cardiac insufficiency and can be used safely.