阿托伐他汀治疗心肌梗死后无症状心力衰竭效果及对预后的影响

Therapeutic effect of atorvastatin on asymptomatic heart failure after myocardial infarction and its influence on prognosis

目的:研究阿托伐他汀对心肌梗死后无症状心力衰竭(AHF)患者的疗效,及对预后的影响。方法:2014年7月~2015年7月本院收治的心肌梗死后AHF患者100例的临床资料,根据随机数字表法,患者被随机均分为常规治疗组和阿托伐他汀组(在常规治疗组基础上加用阿托伐他汀)。测量比较两组治疗前后心功能指标、血浆BNP、NT-proBNP水平、6min步行距离(6MWD)和心功能评分;疗程1年。结果:与治疗前比较,两组治疗后左室射血分数(LVEF)、6MWD均显著增加,左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、血浆BNP、NT-proBNP水平和心功能评分显著降低(P均=0.001)。与常规治疗组比较,阿托伐他汀组治疗后LVEF[(52.48±8.65)%比(57.86±9.70)%]和6MWD[(262.60±12.40)m比(282.65±15.50)m]升高更显著,LVESd[(36.23±2.13)mm比(30.08±2.05)mm]、LVEDd[(58.61±6.40)mm比(51.25±6.18)mm]、血浆BNP[(267.48±42.10)pg/ml比(149.40±32.30)pg/ml]、NT-proBNP水平[(524.65±138.60)pg/ml比(406.20±112.45)pg/ml]和心功能评分[(2.30±0.22)分比(1.15±0.10)分]降低更显著(P均<0.01)。结论:阿托伐他汀能缓和心肌梗死后无症状心力衰竭患者左心室重构,降低血浆BNP、NT-proBNP水平,促进心功能改善,值得推广。

Objective： To study therapeutic effect of atorvastatin on patients with asymptomatic heart failure （AHF） after myocardial infarction, and its influence on prognosis. Methods： Clinical data of 100 AHF patients after myo- cardial infarction, who were treated in our hospital from Jul 2014 to Jul 2015, were analyzed. According to random number table, patients were randomly and equally divided into routine treatment group and atorvastatin group （received atorvastatin based on routine treatment）. Cardiac function indexes, plasma levels of BNP and N-terminal pro B-type natriuretic peptide （NT-proBNP）, 6min walking distance （6MWD） and cardiac function score were measured and compared between two groups before and after treatment. Course of treatment was one year. Results： Compared with before treatment, after treatment, there were significant rise in left ventricular ejection fraction （LVEF） and 6MWD, and significant reductions in left ventricular end-diastolic dimension （LVEDd）, left ventricular end-systolic dimension （LVESd）, plasma levels of BNP and NT-proBNP, and cardiac function score in both groups （P = 0. 001 all）. Compared with routine treatment group after treatment, there were significant rise in LVEF [（52.48±8.65）% vs. （57.86±9.70）%] and6MWD[ （262.60±12.40） mvs. （282.65±15.50） m], and significant reductions in LVESd[（36. 23± 2. 13） mm vs, （30. 08 ± 2.05） mm], LVEDd U （58.61 ± 6.40） ram vs. （51.25± 6.18） mm], plasma levels of BNP [（267. 48 ± 42.10） pg/ml vs. （149.40 ± 32.30） pg/ml] and NT-proB- NP [ （524. 65 ± 138.60） pg/ml vs. （406.20 ± 112.45） pg/ml], and cardiac function score[（2.30 -± 0.22） scores vs. （1.15±0.10） scores] in atorvastatin group （P〈0.01 all） remodeling, reduce plasma levels of BNP and NT-proBNP, cardial infarction, which is worth extending. Key words： Heart failure; Myocardial infarction; Conclusion： Atorvastatin can alleviate left ventricular and improve cardiac function in AHF patients after myo-cardial infarction, which is worth extending.