两种剂量瑞舒伐他汀对急性心肌梗死患者血清心肌营养素1水平及心功能的影响

Effects of different doses of rosuvastatin on serum concentration of cardiotrophin-1 and cardiac function in acute myocardial infarction patients

目的 探讨不同剂量瑞舒伐他汀对急性心肌梗死（AMI）患者血清心肌营养素1（CT-1）水平及心功能的影响.方法 将112例AMI患者按照用药剂量分为2组,瑞舒伐他汀常规剂量治疗组（常规剂量组,60例）患者在常规应用阿司匹林、氯吡格雷、硝酸盐类、β受体阻滞剂等药物治疗基础上加服瑞舒伐他汀10 mg/d;瑞舒伐他汀强化剂量治疗组（强化剂量组,52例）患者在常规药物治疗基础上加服瑞舒伐他汀20 mg/d.另完全随机选取40例体检正常者作为对照组.对照组于AMI患者用药前,常规剂量组、强化剂量组分别于用药前及用药后4周空腹静脉采血检测CT-1水平并检查超声心动图指标,包括左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）和左心室射血分数（LVEF）.结果 用药前常规剂量组、强化剂量组CT-1水平、LVEDD及LVESD[（333 ±53） ng/L、（339 ±51）ng/L,（59.5±6.4）mm、（58.2±7.6） mm,（40.7 ±7.4） mm、（40.4 ±6.2） mm]明显高于对照组[（42.6±11.2） ng/L,（38.2±1.8）mm,（30.2±1.2）mm],LVEF[（41.1±6.8）％、（41.4±7.2）％]明显低于对照组[（58.2±0.9）％],用药后4周,CT-1水平、LVEDD及LVESD[（152 ±28） ng/L、（108± 19）ng/L,（52.1 ±6.1）mm、（46.4±4.9）mm,（34.5 ±4.6）mm、（30.9±4.2）mm]明显降低,LVEF明显升高[（47.5±6.1）％、（52.8±6.2）％],差异均有统计学意义（P＜0.05）.与常规剂量组比较,强化剂量组上述指标改善更为明显（P＜0.05）.结论 瑞舒伐他汀可有效降低患者CT-1水平,抑制心室重塑,改善患者心功能.

Objective To investigate the effects of different doses of rosuvastatin on serum concentration of cardiotrophin-1 （CT-1） and cardiac function in acute myocardial infarction （AMI） patients.Methods One hundred and twelve AMI patients were randomly divided into two groups.The conventional dose rosuvastatin group （60 cases） took 10 mg/d rosuvastatin in addition to routine therapy （such as aspirin clopidogrel nitrate and β-blocker） ; the strengthening dose group（52 cases） took 20mg/d rosuvastatin in addition to routine therapy.40 cases of normal physical examination were randomly selected as the control group.The levels of CT-1,left ventricular enddiastolic diameter（LVEDD）,left ventricular end-systolic dimension（LVESD） and ejection fraction（EF） were all measured in three groups before and after 4 weeks treatment.Results Before treatment,the levels of CT-1,LVEDD and LVESD in the conventional dose group and the strengthening dose group [（333 ± 53） ng/L,（339 ± 51） ng/L ; （59.5 ± 6.4） mm,（58.2 ± 7.6） mm ; （40.7 ± 7.4） mm,（40.4 ± 6.2） mm] were significantly higher than those in the control group [（42.6 ± 11.2） ng/L,（38.2 ± 1.8） mm,（30.2 ± 1.2） mm] （P 〈 0.05） ; the levels of EF[（41.1 ± 6.8）%,（41.4 ± 7.2）%] were significantly lower than those in the control group[（58.2 ± 0.9） %] （P 〈 0.05）.After 4 weeks later,the levels of CT-1,LVEDD and LVESD were all decreased significantly [（152±28） ng/L,（108± 19）ng/L;（52.1 ±6.1） mm,（46.4 ±4.9）mm;（34.5 ±4.6）mm,（30.9 ±4.2）mm] ; the levels of EF were increased[（47.5 ± 6.1） %,（52.8 ± 6.2） %].Conclusion Rosuvastatin can inhibit ventricular remodeling and improve cardiac function and long term prognosis.