阿托伐他汀在慢性心力衰竭治疗中的作用

Therapeutic efficacy of atorvastatin on patients with chronic heart failure

目的观察口服中等剂量阿托伐他汀对慢性心力衰竭患者心功能和心肌重塑的影响。方法选取确诊为非缺血性心力衰竭的患者83例,随机将入选对象分为试验组(n=42)与对照组(n=41),试验组在标准心力衰竭治疗基础上加服阿托伐他汀40 mg/d,治疗期1年,比较两组治疗前后患者心脏功能、生化指标的变化。结果试验组治疗前心功能分级为(2.4±0.3)级,治疗后(3.3±0.2)级(P<0.01)左心室射血分数治疗前为(46.6±3.8)%,治疗后为(38.0±5.8)%(P<0.01);对照组治疗前心功能分级为(2.5±0.6)级,治疗后为(3.2±0.3)级(P<0.05);左心室射血分数为(43.6±4.9)%,治疗后为(39.9±6.7)%(P>0.05)。结论非缺血性心力衰竭患者在标准心力衰竭治疗的基础上加用中等剂量阿托伐他汀治疗安全、有效,可显著改善该类患者心功能和心肌重塑。

Objective To observe the effect of atorvastatin on cardiac function and left ventricular remodeling in patients with chronic heart failure. Methods The 83 cases with non-ischemic heart failure were randomly divided into trial group （n=42） and control group （n--41） in author＇s hospital from May 2007 to Dec. 2011. The two groups were given conventional therapy. Trim group was added atorvastatin 40 mg/d for 12 months. Heart function and biochemical changes of the two groups were observed and compared. Results After 12 months of treatment, the New York Heart Association（NYHA） classification were[（2.4~0.3） grade vs （3.3~0.2）grade,P〈 0.01] and left ventricular ejection fraction （LVEF）,[46.6%＋3.8% vs 38.0%~5.8%,P〈0.01],and the above indexes of trial group were improved significantly （P〈0.01）; while NYHA classification of control group was improved [（2.5~ 0.6） grade vs （3.2＋0.3）grade,P〈0.05], its LVEF showed improved tendence, but had no statistical significance （43.6%~4.9% vs 39.9%＋6.7% ,P〉0.05）. Conclusion For patients with non-ischemic heart failure treating with atorvastatin on the basis of conventional treatment can significantly improve their cardiac function and left ventricular remodeling, and it is safe and effective.