氟伐他汀对扩张型心肌病心室重构和血浆脑钠肽水平的影响

Effects of fluvastatin on ventricular remodeling and blood plasma BNP levels in dilated cardiomyopathy

目的：探讨氟伐他汀对扩张型心肌病（ DCM ）心室重构和血浆脑钠肽（ BNP ）水平的影响。方法选择64例DCM患者，采用随机数字表法分为干预组与对照组各32例。两组均采用常规药物治疗，包括血管紧张素转换酶抑制剂、β受体阻滞剂、利尿剂等。干预组在常规药物治疗基础上加用氟伐他汀40 mg／d。两组均于干预前及干预6个月后分别检查血浆BNP水平及心室重构各项指标，采用Pearson单因素相关分析比较各指标的相关性。结果干预组总有效率明显优于对照组（87．51％与65．63％，χ^2＝4．730，P＜0．05）；两组干预6个月后，血浆BNP水平明显下降，左室射血分数（ LVEF）、左室收缩末内径（ LVESD）、左室舒张末内径（ LVEDD）及相对室壁厚度（ RWT）均明显改善。 BNP水平与LVEF和RWT均呈负相关（ r＝－0．45、－0．39，均P＜0．05），与LVESD和LVEDD均呈正相关（r＝0．35、0．44，均P＜0．05）。结论氟伐他汀能明显降低DCM血浆BNP水平，改善心室重构。

Objective To discuss fluvastatin intervention on ventricular remodeling and plasma brain natri-uretic peptide（ BNP） levels in dilated cardiomyopathy（ DCM） .Methods 64 cases of DCM patients were selected and randomly divided into the intervention group and control group,each group in 32 cases.Both groups were treated with conventional drug therapy, including angiotensin-converting enzyme inhibitors,β-blockers, diuretics, etc.In conven-tional drug treatment intervention group based on the use of fluvastatin 40mg/d.Intervention in both groups before and 6 months after the intervention,plasma BNP levels were examined and ventricular remodeling indicators,analyzed and compared using Pearson Univariate correlation of each index.Results The total efficiency of the intervention group was higher than that of the control group（87.51%vs 65.63%,χ^2 =4.730,P〈0.05）;6 months after the interven-tion groups,plasma BNP levels were significantly decreased left ventricular ejection fraction（LVEF）,left ventricular end systolic diameter（LVESD）,left ventricular end-diastolic diameter（LVEDD） and relative wall thickness（RWT） were significantly improvements.BNP levels and LVEF and RWT was negatively correlated（ r=-0.45,-0.39,all P〈0.05）;Positively correlated with LVESD and LVEDD showed（r=0.35,0.44,all P〈0.05）,the difference was statistically significant.Conclusion Fluvastatin intervention can significantly reduce plasma BNP levels in DCM and improve ventricular remodeling.