瑞舒伐他汀辅助治疗2型糖尿病并发心力衰竭58例

Effect of Rosuvastatin on 58 Patients with Type 2 Diabetic Mellitus Combined with Heart Failure

目的探讨瑞舒伐他汀对2型糖尿病并发心力衰竭(心衰)患者心功能、血浆脑钠肽(BNP)及血清超敏C反应蛋白(hsCRP)水平的影响。方法 2型糖尿病并发心衰患者120例,按照随机数字表法分为对照组及治疗组各60例。两组患者均给予降血糖治疗和抗心衰治疗。治疗组在此基础上给予瑞舒伐他汀10 mg.d-1,po,qd。24周后检测两组患者心功能及血脂、血浆BNP、血清hsCRP水平。结果两组患者血清hsCRP水平和血浆BNP水平随着心功能分级的升高而升高,呈正相关(r=0.821,P<0.01);随着左室射血分数(LVEF)值下降而升高,呈明显负相关(r=-0.730,P<0.01);不同心功能分级组之间观察指标差异均有统计学意义(P<0.05)。治疗24周后,治疗组(失访2例,最后观察58例)和对照组临床疗效的总有效率分别为93.1%和78.3%(P<0.05);两组BNP、hsCRP水平下降(P<0.05),LVEF升高(P<0.05),且以治疗组变化更明显,两组差异有统计学意义(P<0.05)。结论瑞舒伐他汀能降低糖尿病并发心衰患者BNP及hsCRP水平,改善心功能,提高治疗心衰的疗效。

Objective To observe the effects of rosuvastatin on left ventricular function, brain natriuretic peptide （BNP） and high sensitive C-reactive protein （hsCRP） in type 2 diabetic patients with heart failure （HF）. Methods All 120 type 2 diabetic patients with HF were randomly and evenly divided into two groups： control group and treatment group. All patients received basic treatment of type 2 diabetic mellitus and heart failure. Not only that, the patients in the treatment group were treated with rosuvastatin （10 mg d 1 ）. After 24 weeks, the changes of cardiac function, the levels of BNP, lipids, and hsCRP were detected and compared. Results In both groups, the levels of BNP and hsCRP were positively correlated with heart function [ according to the New York Heart Association （NYHA） Functional Classification] （r = 0. 821, P〈0.01 ）, and negatively correlated with left ventricular ejection fraction （LVEF） （r=-0. 730, P〈0.01 ）. The levels of BNP and bsCRP were significantly different between the patients with different classification of heart function （ P〈0.05 ）. After treatment of type 2 diabetic mellitus and heart failure for 24 weeks, there was significant difference in the total effective rate between the treatment group and the control group （93.1% vs. 78.3% , P〈O. 05 ）, and the levels of BNP and hsCRP in both groups were significantly decreased （ P〈0.05 ） , LVEF was significantly increased （ P〈O. 05 ）. The treatment group had more significant changes in the levels of BNP, hsCRP and LVEF than the control group. Conclusion The increasing levels of BNP and hsCRP reflect clinical severity of type 2 diabetes patients with HF. Rosuvastatin can decrease the levels of BNP and hsCRP, and improve heart function, and it is effective in treating type 2 diabetes patients with HF.