瑞舒伐他汀钙对慢性心力衰竭患者血清炎性因子及心功能的影响

目的探讨瑞舒伐他汀钙对慢性心力衰竭（CHF）患者血清超敏c反应蛋白（hs-CRP）、可溶性白细胞分化抗原40配体（sCD40L）水平、白细胞介素．6（IL-6）和白细胞介素-18（IL-18）水平及心功能的影响。方法CHF患者80例，采用随机数字表法分为观察组和对照组各40例，两组患者均根据2014年中国心力衰竭诊断和治疗指南给予常规治疗，观察组在此基础上加用瑞舒伐他汀钙片，分别于治疗前及治疗12周时检测血清hs．CRP、sCD40L、IL-6及IL-18水平，应用彩色多普勒超声诊断仪测定左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）和左心室射血分数（LVEF），采用6分钟步行试验（6MWT）测定步行距离。结果两组患者治疗前血清IL-6、IL-18、hs-CRP）及sCD40L水平相似，差异无统计学意义（P〉0．05）；治疗12周时，两组患者血清IL-6、IL-18、hs-CRP及sCD40L水平较本组治疗前均明显降低，且观察组降低幅度大于对照组，差异均有统计学意义（P〈0．05）。两组患者治疗前LVESV、LVEDV、LVEF、6MWT及NYHA分级比较，差异无统计学意义（P〉0．05）；治疗12周时，两组LVESV、LVEDV、LVEF、6MWT及NYHA分级较本组治疗前均明显改善，且观察组改善幅度明显大于对照组，差异有统计学意义（P〈0．05）。结论瑞舒伐他汀钙能降低CHF患者血清炎症介质IL-6、IL-12、hs-CRP及sCD40L水平，逆转心室重构，进而改善心脏功能，对治疗CHF具有积极的作用，值得临床推广。

Objective To investigate the effects of rosuvastatin calcium on the heart function and serum levels of hypersensitive C reactive protein （ hs-CRP ） , soluble CD40 ligand （ sCD40L ） , interleukin-6 （ IL-6 ） , and interleukin-18 （ IL-18 ） in patients with chronic heart failure （ CHF ） . Methods A total of 80 eligible patients were selected and randomly divided into observation group and control group, with 40 patients in each group. The patients of both groups were given conventional therapies complying with Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2014, while the observation group used Rosuvastatin Calcium Tablets additionally, and the serum levels of hs-CRP, sCD40L, IL-6, and IL-18 were determined, left ventricular end-systolic volume （ LVESV ） , left ventricular end-diastolic volume （ LVEDV ） , and left ventricular ejection fraction （ LVEF ） were determined by color Doppler ultrasonography, and walking distances were determined by 6-rain walking test （ 6MWT ） before the treatments and at 12w after the treatments, respectively. Result s Before the treatments, the patients of the two groups had similar IL-6, IL-18, hs-CRP, and sCD40L, and the differences were statistically insignificant （P〉0.05） ; at 12w after the treatments, both groups had significantly decreased IL-6, IL-18, hs-CRP, and sCD40L when compared with those before the treatments, and the observation group had significantly greater decreasing extents than the control group （ both P〈0.05 ） . Before the treatments, the patients of the two groups had similar LVESV, LVEDV, LVEF, 6MWT, and NYHA class, and the differences were statistically insignificant （ P〉0.05 ） ; at 12w after the treatments, both groups had significantly improved LVESV, LVEDV, LVEF, 6MWT, and NYHA class when compared with those before the treatments, and the observation group had significantly greater improving extents than the control group （ both P〈0.05 ） . Conclusion Rosuvastatin calcium can decrease the serum levels of IL-6, IL-18, hs-CRP, and sCD40L, inverse cardiac ventricular remodeling, and then improve heart function in patients with CHF, has positive effects on CHF, and consequently is worthy of clinical application.