他汀类药物治疗改善患者心脏舒张功能与降低运动后脑利钠肽水平的作用

Effect of statin on improves cardiac diastolic function and reduces exercise B-type natriuretic peptide level

目的评价他汀类药物治疗对心脏舒张功能及运动后血浆脑利钠肽(BNP)水平的影响。方法随机将60例心脏舒张功能不全合并运动高血压患者分成阿托伐他汀治疗组和对照组各30例。在原有治疗基础上,治疗组加用阿托伐他汀20 mg,每晚1次,对照组则加用安慰剂,疗程1年。测定治疗前后患者的心功能、运动心肺功能和运动后血浆BNP浓度。结果治疗后,治疗组的二尖瓣血流频谱E峰与A峰比值(E/A)有明显改善,运动时间延长,运动当量、运动最大摄氧量、无氧阈值均明显增大,运动BNP明显下降,与治疗前相比差异均有统计学意义(P<0.05);治疗后与对照组相比,E/A、运动时间、运动BNP浓度差异有统计学意义(P<0.05)。结论阿托伐他汀治疗能改善心脏舒张功能,降低运动BNP水平,提高运动耐量。

Objective To evaluate the effects of statin on cardiac dias-tolic function and the level of B -type natriuretic peptide （ BNP） to exer-cise.Methods A total of 60 patients with diastolic dysfunction and a hypertensive response to exercise were divided into atorvastatin treatment group（ n =30, atorvastatin 20 mg, once every night ） and the placebo group（n=30）.The course of treatment was one year , all patients con-tinued their original therapy.Echocardiography , cardiopulmonary exer-cise testing , and the plasma BNP concentration determination at peak exercise were performed before and after treatment.Results After ator-vastatin treatment , the mitral flow velocity E wave to A wave peak veloci-ties（ E/A ratio） were improved.The exercise time extended , metabolic equivalents , maximal oxygen uptake and anaerobic threshold were increased , and the exercise BNP values reduced.All of parameters had significant difference from baseline （P〈0.05）, only the E/A ratio,the exercise time and the exercise BNP values had significant difference com-pared with placebo （ P〈0.05 ）.Conclusion Atorvastatin improves car-diac diastolic function , decreases exercise BNP level , increases exercise tolerance.