不同剂量阿托伐他汀联合二丁酰环磷酰苷钙对冠心病合并慢性心衰患者心功能及NT-proBNP的影响

Effects of different doses of Atorvastatin combined with Two dibutyryl cyclic adenosine phosphate calcium glycosides on cardiac function and NT-proBNP in patients with coronary heart disease complicated with chronic heart failure

目的：探讨不同剂量阿托伐他汀联合二丁酰环磷酰苷钙对冠心病合并慢性心衰患者心功能及NT-proBNP的影响。方法：选择2015年6月到2016年12月之间在我医院心内科进行住院治疗的，冠心病合并慢性心力衰竭患者共116例，按照患者所采用的治疗方法进行分组，分别为对照组，低剂量组，中剂量组和高剂量，每个组29名患者，对照组患者在入院后施行常规治疗，观察组患者在对照组治疗方法的基础上，给予阿托伐他汀联合二丁酰环磷酰苷钙，不同剂量组使用的阿托伐他汀剂量不同，对治疗的效果进行对比。结果：四个组别患者在治疗前的NT-proBNP，C反应蛋白，左心室射血分数和左心室舒张末期内径数据差异不具有统计学意义（P〉0.05）,经过治疗后四个组别的患者在四个项目上的数据与治疗前的数据差异均具有统计学意义（P〈0.05），从结果上看NT-proBNP，C反应蛋白和左心室舒张末期内径三个项目上，均为治疗后的数据低于治疗前的，左心室射血分数为治疗后高于治疗前的，在治疗后的数据中，NT-proBNP，C反应蛋白，左心室射血分数和左心室舒张末期内径四个项目中，不同组别的数据差异均具有统计学意义（P〈0.05），从结果上看，四个项目均只有高剂量组和其他三组之间的数据差异具有统计学意义，其余组间数据差异不具有统计学意义，四个组别患者在不同级别的治疗效果上的数据差异经过Kruskal-Wallis检验显示具有统计学意义（χ2=35.119，P〈0.05）,四个组别的治疗有效率差异也具有统计学意义（χ2=8.627，P〈0.05），bonferonni检验两两比较的χ2检验结果显示，高剂量组与其他三组数据差异具有统计学意义（P〈0.05），对照组，低剂量组和中剂量组时间的数据差异不具有统计学意义（P〉0.05）。结论：使用高剂量阿托伐他汀联合二丁酰环磷酰苷钙对冠心病合并慢性心衰患者进行治疗，可以改善心功能，改善NT-proBNP和C反应蛋白的指标，提升治疗的效果，值得在更广大临床范围内进行推广。

Objective： To investigate the effect of different doses of Atorvastatin Combined with two calcium on calcium phosphate phosphate on cardiac function and NT-proBNP in patients with coronary heart disease complicated with chronic heart failure. Methods： from June 2015 to December 2016 in my hospital department of cardiology hospital treatment, a total of 116 cases of patients with chronic heart failure with coronary heart disease, were grouped according to the treatment of patients with, respectively, control group, low dose group, middle dose group and high dose, 29 patients in each group, control group were treated with routine treatment in after admission, patients in the observation group in the control group based on the method of treatment, given Atorvastatin Combined with two dibutyryl cyclic adenosine phosphate calcium, different dose groups using different doses of atorvastatin, comparing the treatment effect. Results： four groups of patients before treatment NT-proBNP, C reactive protein, left ventricular ejection fraction and left ventricular end diastolic diameter data difference was not statistically significant （P〉0.05）, after treatment in the four item of data and treatment of four groups of patients before the data differences were statistically significant （P〈0.05）, NT-proBNP from the C, C-reactive protein and left ventricular end diastolic diameter on the three projects, all data after treatment was lower than that before the treatment, left ventricular ejection fraction after treatment than those before treatment, after treatment according to the number of NT-proBNP, C, C-reactive protein, left ventricular ejection ejection fraction and left ventricular end diastolic diameter in four projects, the difference of data of different groups were statistically significant （P〈0.05）, the result shows that the four projects are only in high dose group and the other three groups. Statistically significant differences between groups of data data, the difference was not statistically significant, the four groups of patients at different levels of the treatment effect on the data after Kruskal-Wallis test showed that the difference was statistically significant （2=35.119, P〈0.05）, the treatment of the four groups have the efficiency difference was statistically significant （2=8.627, P〈0.05） comparison of bonferonni test, 22 of the 2 test results showed statistically significant high dose group and the other difference between the three groups of data （P〈0.05）, control group, low dose group and time difference data in the middle dose group was not statistically significant （P〉0.05）. Conclusion： the use of high doses of Atorvastatin Combined with two dibutyryl cyclic adenosine phosphate calcium on coronary heart disease patients with chronic heart failure treatment, can improve heart function, improve NT-proBNP and C reactive protein index, improve the therapeutic effect, worthy of promotion in a wider range of clinical.