辛伐他汀联合曲美他嗪治疗48例慢性心力衰竭的临床疗效观察

Effective observation of simvastatin and trimetazidine for treating chronic heart failure in 48 cases

目的观察辛伐他汀和曲美他嗪对慢性心力衰竭(CHF)患者心功能和高敏C反应蛋白(hs-CRP)的影响。方法选择2008年10月至2010年9月该院住院的非缺血性心脏病CHF患者96例,随机分成对照组(n=48)和观察组(n=48)。两组患者均给予常规抗心力衰竭治疗,观察组加服辛伐他汀和曲美他嗪,疗程6个月,比较两组患者治疗前、后心功能分级、心功能指标及血浆hs-CRP水平的变化。结果治疗后观察组总有效率、左心室射血分数(LVEF)、舒张早期最大血流速度/舒张晚期最大血流速度比值[87.50%、(44.45±3.26)%、1.36±0.21]高于对照组[68.75%、(39.53±4.35)%、1.15±0.26,P<0.05],观察组左心室舒张末期容积指数(LVEDVI)、左心室收缩末期容积指数(LVESVI)及hs-CRP[(45.68±3.98)mL/m2、(23.23±5.13)mL/m2、(2.53±0.24)mg/L]低于对照组[(51.88±4.26)mL/m2、(35.46±4.89)mL/m2、(3.98±0.48)mg/L,P<0.05]。结论辛伐他汀联合曲美他嗪治疗CHF疗效确切。

Objective To observe the effect of simvastatin and trimetazidine on the cardic function and serum high sensitivity C-reation protein（hs-CRP）level in the patients with chronic heart failure（CHF）.Methods 96 inpatients with non-ischemic heart disease complicating CHF in our hospital from October 2008 to September 2010 were selected and randomly divided into two groups,the control group and the observation group.All cases received the conventional treatment.But the observation group was added simvastatin 20 mg,once per night and trimetazidine 20mg,three times a day.After 6-month treatment,the serum hs-CRP,left ventricular ejection fraction（LVEF）,left ventricular end-diastolic volume index（LVEDVI）,left ventricular end-systolic volume index（LVESVI）and E/A ratio were examined and compared between the two groups.Results Compared with control group,the NYHA classification of cardiac function in the observation group was obviously improved（P0.05）.LVEF and the E/A ratio were significantly increased（P0.05）,LVEDVI,LVSDVI and hs-CRP in the observation group were significantly decreased（P0.05）.The serum level of hs-CRP was positively correlated with LVEDVI and LVESVI（r=2.85,P0.05）,and negatively correlated with LVEF and the E/A ratio（r=-1.35,P0.05）.Conclusion Simvastatin and trimetazidine might improve cardiac function of the patients with CHF obviously.