阿托伐他汀联合曲美他嗪对冠心病患者心功能、炎性因子及血管内皮功能的影响

Effect of atorvastatin combined with trimetazidine on the cardiac function,inflammatory factors and vascular endothelial function in patients with coronary heart disease

目的探讨阿托伐他汀联合曲美他嗪对冠心病患者心功能、炎性因子及血管内皮功能的影响。方法将128例冠心病患者随机分成对照组与观察组,各64例。对照组给予曲美他嗪治疗,观察组在此基础上加用阿托伐他汀,比较治疗前后2组心功能、炎性因子水平及血管内皮功能的变化。结果治疗后,2组左心室舒张末期内径(LVEDD)、左室后壁厚度(LVPWd)明显降低,而左心室射血分数(LVEF)明显升高(P<0.05或P<0.01),观察组改善程度明显优于对照组(P<0.01)。治疗后,2组肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)及超敏C反应蛋白(hs-CRP)水平均明显降低(P<0.01),且观察组各指标水平明显低于对照组(P<0.01)。治疗后,2组血管内皮素-1(ET-1)和外周血循环内皮微颗粒(c EMPs)水平明显降低,且观察组显著低于对照组P<0.01);一氧化氮(NO)明显升高,且观察组明显高于对照组(P<0.01)。结论阿托伐他汀联合曲美他嗪可明显改善冠心病患者的心功能,降低炎症因子水平,改善血管内皮功能。

Objective To investigate the effect of atorvastatin combined with trimetazidine on the cardiac function, inflammatory factors and vascular endothelial function in patients with coro- nary heart disease （CHD）. Methods Totally 128 patients with CHD were randomly assigned into control group （n = 64） and observation group （n = 64 ）. The patients in control group were treated with trimetazidine, while those in observation group were added atorvastatin. The changes of cardiac function, levels of inflammatory factors and vascular endothelial function were all compared between two groups. Results After treatment, both left ventricular end diastolic diameter （LVEDD） and left ventricular posterior wall depth （LVPWd） decreased significantly, while left ventricular ejection frac- tion （LVEF） increased conspicuously in two groups （P 〈 0.05 or P 〈 0.01 ）, and the improvement degree in observation group was superior to that in control group （P 〈0.01 ）. After treatment, the levels of tumor necrosis factor-α （TNF-α）, matrix metalloproteinase-9 （MMP-9） and high sensitive C-reactive protein （hs-CRP） all went down in two groups （P 〈0.01 ）, and the decreased degree in observation group was larger than that in control group （ P 〈 0.01 ）. After treatment, the levels of both endothelium-1 （ET-1） and circulating endothelial microparticles （cEMPs） in peripheral blood decreased significantly, while that of nitric oxide increased obviously, and observation group were higher in nitric oxide than control group （ P 〈 0. 0 1 ） . Conclusion Atorvastatin combined with trimetazidine can effectively ameliorate the cardiac function, reduce the levels of inflammatory factors and improve vascular endothelial function of patients with CHD.