氟伐他汀对糖尿病心肌病患者血清CTGF及心功能的影响

Effect of Fluvastatin on the Serum CTGF and Cardiac Function in Patients with Diabetic Cardiomyopathy

目的:探讨氟伐他汀治疗对糖尿病心肌病患者血清结缔组织生长因子(CTGF)及心功能的影响。方法:选取2010年1月～2010年12月在黑龙江省医院住院的2型糖尿病(DM2)住院患者,依据糖尿病心肌病诊断标准,筛选出57例(男28,女29)糖尿病心肌病患者,随机分为两组,氟伐他汀治疗组(fluvastatin组)和对照组(control组)。其中fluvastatin组[n=32(男16,女16),年龄(52±9)岁]和control组[n=25(男12,女13),年龄(53±8)岁]。fluvastatin组80mg/d氟伐他汀口服6个月,control组不服用fluvastatin。实验进行6个月后,测定两组患者治疗前及治疗后的血糖、血脂等生化指标及血清CTGF值。此外,治疗前后做心脏彩超检查,测定左室后壁厚度(LVPW),左室舒张末期内径(LVEDD),射血分数(EF),二尖瓣环舒张早期血流峰值运动速度(E/A)。比较两组治疗前后患者生化指标、血清CTGF以及心功能变化。结果:①fluvastatin治疗6个月后,flu-vastatin组血清CTGF[(425.78±63.56)ng/L vs(216.55±72.11)ng/L,P<0.05]显著降低;control组6个月后血清CTGF无显著变化[(436.86±53.21)ng/L vs(429.98±63.77)ng/L,P>0.05]。治疗后两组间血清CTGF有显著的统计学差异(P<0.05)。②fluvastatin治疗6个月后,fluvastatin组患者EF[43.65%±3.89%)vs(51.21%±4.92%),P<0.05]、E/A[(0.74±0.43)vs(1.06±0.59),P<0.05]显著升高;control组6个月后,EF[(41.89%±4.03%)vs(43.65%±5.45%),P>0.05],E/A[(0.71±0.54)vs(0.72±0.47),P>0.05]变化不显著。治疗后两组间EF、E/A有显著差异(P<0.05)。结论::fluvastatin治疗可显著降低糖尿病心肌病患者血清CTGF,并改善心功能。

Objective To explore the effect of Fluvastatin on the serum CTGF and cardiac function in patients with diabetic cardiomyopathy.Methods Candidates were enrolled from diabetic cardiomyopathy inpatients in heilongjiang provincial hospital from january to december,2010.Qualified patients were randomed into two groups,Fluvastatin group（n=32,16 males,16 female,aged 52±9）and control group（n=25,12 males,13 female,aged 53±8）.The patients in the Fluvastatin group received oral Fluvastatin 80mg every night for 6 months,while the control group had no lipid-lowering therapy.Blood glucose,lipid,serum CTGF,cardiac ultrasonography,and clinical data were detected and recorded both before and after the treatment.Results（1） Comparison with pre-treatment,serum CTGF significantly declined in the Fluvastatin group treated with Fluvastatin（425.78±63.56 ng/L vs 216.55±72.11 ng/L,P〈0.05）,and had no remarkable changes in the control group（436.86±53.21ng/L vs 429.98±63.77,P〉0.05） after 6 months.（2） Comparison with pre-treatment,EF and E/A post-treatment in the Fluvastatin group significantly improved（43.65±3.89% vs 51.21±4.92%,0.74±0.43 vs 1.06±0.59,P〈0.05）.And there were on marked remission in the control group（EF 41.89±4.03% vs 43.65±5.45%,E/A 0.71±0.54 vs 0.72±0.47,P〉0.05）.After 6-month therapy,there was a prominent improvement of EF and E/A in the Fluvastatin group（P〈0.05）.Conclusion Fluvastatin could reduce the serum CTGF and improve the cardiac function in patients with diabetic cardiomyopathy.