不同剂量阿托伐他汀治疗冠心病慢性心力衰竭的疗效观察

Clinical Effect of Different Doses of Atorvastatin on Coronary Heart Disease Patients Complicated with Chronic Heart Failure

目的探讨不同剂量阿托伐他汀治疗冠心病慢性心力衰竭的疗效。方法选择2011年1月—2013年1月乐陵市人民医院心内科收治的96例冠心病慢性心力衰竭患者,随机分为对照组和治疗组,每组48例。对照组和治疗组患者在常规治疗基础上分别给予阿托伐他汀20 mg/d、40 mg/d口服,比较两组患者治疗前后左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)及6分钟步行距离(6MWT)及血清N-末端脑利钠肽前体(NT-pro BNP)、超敏C反应蛋白(hs-CRP)水平;随访6个月,比较两组患者心源性死亡情况和心力衰竭复发住院情况。结果两组患者治疗前LVEF、LVEDD、LVESD比较,差异无统计学意义(P>0.05);治疗后治疗组患者LVEF高于对照组,LVEDD、LVESD低于对照组(P<0.01)。治疗前两组患者血清NT-pro BNP、hs-CRP水平及6MWT比较,差异均无统计学意义(P>0.05);治疗后治疗组血清NT-pro BNP、hs-CRP水平低于对照组,6MWT长于对照组(P<0.05)。治疗组患者心源性死亡率、心力衰竭复发住院率均低于对照组(P<0.05)。结论阿托伐他汀40 mg/d口服治疗冠心病慢性心力衰竭疗效更优,安全性较高,有利于改善患者预后。

Objective To explore the clinical effect of different doses of atorvastatin on coronary heart disease patients complicated with chronic heart failure. Methods From January 2011 to January 2013,96 coronary heart disease patients complicated with chronic heart failure were selected in People＇s Hospital of Leling,and they were randomly divided into control group and treatment group,48 cases in each group. Both groups given routine treatment, and control group given extra atorvastatin（20 mg/d）,while treatment group given atorvastatin（40 mg/d）. Left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter （ LVEDD ）, left ventricular end systolic diameter （ LVEXD ）, 6 - minute walking test （6MWT）,serum levels of N -terminal brain natriuretic peptide precursor（ NT-proBNP） and high -sensitive C -reactive protein（ hs-CRP）were compared between the two groups before and after treatment;cardiac mortality and rehospitalization caused by recurrence of heart failure were compared after 6-month fellow-up. Results There was no significant differences of LVEF,LVEDD,LVEXD,serum levels of NT-proBNP and hs-CRP,6MWT between the two groups before treatment（ P﹥0. 05）;after treatment,LVEF of treatment group was higher than that of control group,LVEDD,LVEXD,serum levels of NT-proBNP and hs-CRP were lower than those of control group,6MWT of treatment group was longer than that of control group （P﹤0. 05）. Cardiac mortality and rehospitalization rate of treatment group were lower than those of control group（P﹤0. 05）. Conclusion The curative effect of atorvastatin（40 mg/d） in treating coronary heart disease patients complicated with chronic heart failure is better,more safe and more helpful to improve the prognosis.