阿托伐他汀改善心肌梗死后无症状心力衰竭患者心功能的效果研究

Clinical effects of atorvastatin in improving heart function of patients with asymptomatic heart failure after myocardial infarction

目的研究阿托伐他汀改善心肌梗死后无症状心力衰竭(SHF)患者心功能的临床效果。方法选取2011年3月—2014年3月浚县惠民医院收治的心肌梗死后SHF患者105例,随机分为常规组52例和他汀组53例。常规组给予常规抗心力衰竭基础治疗,他汀组在常规组基础上加用阿托伐他汀治疗,比较两组治疗前后氨基末端利钠肽前体(NT-pro BNP)水平、心脏超声指标〔左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)〕和6min步行试验距离。结果两组患者治疗前NT-pro BNP水平、心脏超声指标、6min步行试验距离比较,差异无统计学意义(P>0.05);治疗后他汀组NT-pro BNP水平、LVESD和LVEDD低于常规组,LVEF高于常规组,6min步行试验距离长于常规组,差异有统计学意义(P<0.05)。结论阿托伐他汀能够改善心肌梗死后SHF患者的心功能和心室重构,降低病死率、提高生存质量,在延缓和阻滞疾病进行性加重方面具有重要意义。

Objective To study the clinical effects of atorvastatin in improving heart function of patients with asympto-matic heart failure（SHF）after myocardial infarction. Methods From March 2011 to March 2014 in Huimin Hospital of Jun, a total of 105 patients with acute myocardial infarction were selected,they were randomly divided into convention group（n =52）and statins group（n = 53）. Convention group were treated with routine anti heart failure therapy,statins group were trea-ted with atorvastatin on the basis of routine treatment. Before and after treatment N - terminal natriuretic peptide（NT proBNP） levels and heart ultrasound index〔left ventricular end systolic diameter（LVESD）,left ventricular diastolic end diastolic diam-eter（LVEDd）,left ventricular shoot ejection fraction（LVEF）〕and 6 - minute walking test between the two groups were com-pared. Results Before treatment NT - proBNP levels,heart ultrasound index,6 - minute walking test distance between the two groups showed no significant differences（P ﹥ 0. 05）;after treatment,NT - proBNP levels,LVESD and LVEDD of statins group were lower than the convention group,LVEF was higher than the convention group,6 - minute walking test distance was longer than the convention group,the differences were statistically significant（P ﹤ 0. 05）. Conclusion Atorvastatin can im-prove cardiac function and ventricular remodeling of patients with SHF after myocardial infarction,reduce the mortality,improve the quality of life,and has important significance in delaying and preventing the disease of the SHF.