氟伐他汀对慢性心力衰竭患者心功能及标志物的影响

Effect of Fluorine on chronic heart failure patients with cardiac function and markers

目的:观察氟伐他汀短期应用对慢性心力衰竭(CHF)患者心功能[左室射血分数(LVEF)]、B型尿钠肽(BNP)、丙二醛的影响。方法:入选2008年1月至2009年1月在我院收治的CHF住院患者80例,男48例,女32例,年龄35～72(62±9)岁,按NYHA分级(Ⅱ～Ⅲ级)随机分成治疗组(n=40例)和对照组(n=40例)。治疗组在对照组的基础上加用氟伐他汀80 mg,共12周。治疗前后检查心脏超声,评估心功能,侧定BNP、丙二醛和血脂水平。结果:12周后,治疗组总胆固醇[(4.0±0.5)比(4.5±0.8)mmol/L,P<0.05]、三酰甘油[(1.3±0.6)比(1.5±0.5)mmol/L,P<0.05)]、低密度脂蛋白胆固醇[LDL-C,(2.1±0.4)比(2.5±0.6)mmol/L,P<0.05]较对照组明显降低,差异具有统计学意义。与治疗前比较,两组LVEF有明显改善,治疗组较对照组改善更明显[(55.4%±5.2%)比(46.4%±4.5%),P<0.05];且BNP水平治疗后有明显降低,治疗组较对照组更为明显[(203.1±45.1)比(301.2±50.3)ng/L;丙二醛(4.8±1.8)比(7.7±1.1)gmol/L;P<0.05]。结论:氟伐他汀短期应用能改善心脏功能,减少心肌细胞损害,有益于慢性心力衰竭的治疗。

Objective：To observe the effect of short-term application of Fluvastatin on cardiac function（left ventricular ejection fractions,LVEF）,Brain natriuretic peptide（BNP） and malondialdehyde（MDA） in patients with chronic heart failure（CHF）.Methods：80 cases who admitted to our hospital for CHF（NYHA grade Ⅱ-Ⅲ grade） form Jan,2008 to Jan,2009 were randomly divided into treatment group（n = 40 cases） and control＇group（n = 40 cases）.Among all teases patients,age 35~72（62±9）years,48 were male and 32 were female.Treatment group was given Fluvastatin 80mg for 12 weeks compared with control group.by doing cardiacul trasound examination to evaluate the treatment.The results were evaluated by doing Doppler-Echocardiography examination,assessing cardiac function,and Monitoring the level of BNP,MDA and lipid before and after treatment.Results： After 12 weeks of treatment,we compared treatment group with control group,the results showed that the indices which included the total cholestero（4.0±0.5mmol/L VS 4.5±0.8 mmol/L,P0.05）,triglyeride（1.3±0.6mmol/L VS 4.51.5 ±0.5 mmol/L,P0.05）,low density lipoprotein-cholesterol（LDL-C,2.1±0.4mmol/L VS 2.5±0.6 mmol/L,P0.05） were decreased markedly.The indices which included the cardiac function（according to NYHA classification） and left ventricular ejection fraction were improved both in treatment group and control group after treatment,however,the indices of the treatment group were improved markedly compared with control group [LVEF（55.4%±5.2% VS 46.4%±4.5%,P0.05）];The indices which included the level of BNP and MDA were decreased both in treatment group and control group after treatment,but it was more decreased significantly in the treatment group compared with control group [BNP（203.12±45.12ng/L VS 301.23±50.34 ng/L）;MDA（4.78±1.82 gmol/L VS 7.68±1.12 gmol/L）;P0.05）].Conclusions： Short-term application of Fluvastatin can improve heart function,reduce myocardial cell damage and is wholesome for the treatment of chronic heart failure.