阿托伐他汀对慢性心衰sCD40L、BNP水平的影响

Effects of Atorvastatin on sCD40L and BNP in Patients with Chronic Heart Failure

目的观察慢性心衰患者sCD40L和BNP水平的变化及阿托伐他汀对其影响,探讨其在慢性心衰中的临床应用价值。方法将118例心衰患者随机分为阿托伐他汀治疗组(干预组,n=59)和对照组(n=59),对照组采用强心剂、利尿剂、血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂及β-受体阻滞剂等常规治疗。干预组在常规治疗基础上加服阿托法他汀20 mg。两组患者治疗前和治疗6个月后分别查血脂、BNP及sCD40L水平的变化。结果结果显示sCD40L与LVEF呈负相关,血脂和BNP的变化与sCD40L呈正相关。治疗后血清BNP及sCD40L均较治疗前有明显下降,阿托法他汀治疗组效果更明显(P<0.05)。结论慢性心衰患者sCD40L表达水平明显升高,与BNP呈正相关。阿托伐他汀可以降低心衰时血清sCD40L水平s,CD40L可作为心衰预测的新指标。

Objective To observe the changes of sCD40L and brain natriuretic peptide （BNP） levels in patients with chronic heart failure（CHF）, determine the infection of Atorvastatin on them,and to investigate the clinical application value in CHF. Methods 118 patients were randomly divided into Atorvastatin and control groups. Patient in control group （n = 59） were received conventional therapy include diuretics,vasodilators,antagonist converting enzyme inhibitors（ACEI） or angiotension receptor antagonist and β-receptor blocker. Patients in the research group were given Atorvastatin 20 mg based on conventional therapy. The changes of serum cholesterol, BNP and sCIMOL levels of each group were measured before and after 6 month＇ s therapy. Results sCD40L was negatively correlated with left ventricular ejection fraction （LVEF） and positively correlated with the change of serum cholesterol. The serum BNP and sCD40L levels were obviously decreased after treatment. The effect of the Atorvastatin group was more than the control group （ P 〈 0.05 ）. Conclusion sCD40L expression level was significantly increased in patient with CHF, and positively correlated with BNP,which can be used as a new marker in CHF prediction. Atorvastatin can reduce the level of sCD40L associated with CHF.