阿托伐他汀联合rhBNP治疗对急性心力衰竭患者血浆TGF-β1与心功能的影响

Effect of atorvastatin combined with rhBNP on plasma TGF-β1 and cardiac function in patients with acute heart failure

目的研究急性心力衰竭(AHF)患者经阿托伐他汀与外源性脑利钠肽(rh BNP)治疗后血浆转化生长因子-β1(TGF-β1)与心功能的关系。方法选择AHF患者116例,依据随机数字表法将患者分成观察组和对照组,各58例,两组均给予常规治疗,对照组加用阿托伐他汀,观察组在对照组的基础上另加用rh BNP治疗,对比两组血浆N末端脑钠肽原(NT-pro BNP)及TGF-β1水平,心功能指标以及治疗前后的NYHA分级,分析指标间的相关性。结果治疗后组内比较,两组的血浆NT-pro BNP及TGF-β1水平均明显低于治疗前,差异有统计学意义(P<0.05)。治疗后组间比较,观察组的血浆NT-pro BNP(334.28±121.06)ng·L^(-1)及TGF-β1水平(134.13±26.13)ng·L^(-1)均明显低于对照组的(510.79±114.63)ng·L^(-1)及(280.29±27.64)ng·L^(-1),差异有统计学意义(P<0.05)。治疗后组内比较,两组的左室射血分数(LVEF)明显高于治疗前,左心室舒张末期容积(LVEDV)及左心室收缩末期容积(LVESV)水平明显低于治疗前,差异有统计学意义(P<0.05)。治疗后组间比较,观察组的LVEF(40.74±5.18)%明显高于对照组的(38.20±3.25)%,LVEDV(105.24±11.38)m L及LVESV水平(51.29±9.36)m L明显低于对照组的(111.87±10.63)m L及(60.39±8.72)m L,差异有统计学意义(P<0.05)。治疗后观察组的NYHA分级明显低于对照组,差异有统计学意义(P<0.05)。根据Spearman法分析相关性发现,患者血浆NT-pro BNP及TGF-β1均与NYHA分级呈正相关(r=0.721,0.764;均P<0.05)。结论阿托伐他汀联合rh BNP治疗AHF能够明显降低患者的血浆TGF-β1水平,并改善其心功能,效果明显,值得推荐。

Objective To study the relationship between plasma TGF-β1 and cardiac function in patients with acute heart failure trea-ted with atorvastatin and rhBNP. Methods One hundred and sixteen patients with AHF from March 2013 to September 2015 in Shunde District Lecong Hospital of Foshan City according to simple random number table method were assigned into observation group and con-trol group,58 cases in each. Two groups were given conventional therapy. The control group was treated with atorvastatin while the ob-servation group was given atorvastatin combined with rhBNP treatment. Plasma N terminal brain natriuretic peptide（NT-proBNP）,TGF-β1 level,cardiac function index,before and after the treatment of NYHA classification,as well as the correlation between indexes were compared and analyzed. Results After treatment,the plasma levels of NT-proBNP and TGF-β1 in the two groups were significantly lower than that before treatment. The differences were statistically significant（P 〈 0. 05）. After treatment,the plasma levels of NT-proB-NP（334. 28 ± 121. 06） ng·L - 1 and TGF-β1（134. 13 ± 26. 13） ng·L - 1 in the observation group were significantly lower than those in the control group of（510. 79 ± 114. 63） ng·L - 1 and（280. 29 ± 27. 64） ng·L - 1 ,with the differences statistically significant（P ＆lt;0. 05）. After treatment,left ventricular shot ejection fraction（LVEF） was significantly higher than those before treatment in the treat-ment group,left ventricular diastolic end diastolic volume（LVEDV） and left ventricular end systolic volume（LVESV） levels were sig-nificantly lower than that before treatment,with statistically significant differences（ P ＆lt; 0. 05）. After treatment,the LVEF（40. 74 ± 5. 18）% of the observation group was significantly higher than that of the control group of（38. 20 ± 3. 25）% . LVEDV（105. 24 ± 11. 38） mL and LVESV levels（51. 29 ± 9. 36） mL were significantly lower than the control group of（111. 87 ± 10. 63） mL and （60. 39 ± 8. 72） mL,the differences of which were statistically significant（P ＆lt; 0. 05）. After treatment,the NYHA grade of the observa-tion group was significantly lower than that of the control group（P ＆lt; 0. 05）. According to the correlation analysis of Spearman,the plas-ma NT-proBNP and TGF-β1 were positively correlated with NYHA grading（r = 0. 721,0. 764;all P ＆lt; 0. 05）. Conclusions Atorvasta-tin statins combined with rhBNP in the treatment of AHF can obviously reduce the patients′ plasma TGF-β1 levels,and improve cardiac function,which has great treatment effect and worth to give recommendation.