曲美他嗪联合阿托伐他汀对慢性心力衰竭患者的疗效及机制分析

The analysis of efficacy and mechanism of trimetazidine combined with a-torvastatin in treatment of patients with chronic heart failure

目的探讨曲美他嗪联合阿托伐他汀对慢性心力衰竭患者的临床疗效。方法 86例CHF患者随机分为观察组和对照组,每组各43例,对照组予常规抗心力衰竭药物治疗,观察组在此基础上给予曲美他嗪联合阿托伐他汀治疗,疗程4周。于治疗前后检测患者血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及相应的心功能指标,包括有左室射血分数(LVEF)和左室舒张末内径(LVEDD),比较观察两组患者临床疗效并分析其作用机制。结果治疗后,观察组的总有效率高于对照组,差异具有统计学意义(P<0.05);观察组和对照组CRP、IL-6、TNF-α、LVEF、LVEDD水平治疗后均优于治疗前,且治疗后观察组指标较对照组改善更明显,差异具有统计学意义(P<0.05)。结论曲美他嗪联合阿托伐他汀治疗CHF患者的临床疗效显著,两种药物协同作用改善机体炎症反应,抑制心室重塑。

Objective To analyze and investigate the clinical efficacy of trimetazidine combined with atorvastatin in patients with chronic heart failure. Methods 86 patients with CHF were randomly divided into two groups,the control group and the observation group,both with 43 cases. The control group received conventional anti-heart failure medi-cations,and on the basis of them the observation group received trimetazidine combined with atorvastatin treatment for a course of 4 weeks. Serum C-reactive protein（CRP）,interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and the corresponding level of cardiac functions including left ventricular ejection fraction（LVEF） and left ventricular end-di-astolic diameter （LVEDD）of patients were detected before and after treatment. The clinical efficacy of the two groups was observed and its action mechanism were compared. Results After treatment, the total effective rate of the observa-tion group was higher than that of the control group,and the difference was statistically significant（P〈0.05）. CRP,IL-6,TNF-α,LVEF and LVEDD levels of the observation group and the control group after treatment were more excellent than those before treatment. Indexes of the observation group improved more significantly than those of the control group, and the difference was statistically significant （P〈0 . 05）. Conclusion The clinical efficacy of Trimetazi-dine combined with atorvastatin in treatment of patients with CHF is significant. The two drugs have a synergistic effect in improving inflammatory response and suppressing ventricular remodeling.