20 mg和40 mg剂量阿托伐他汀对缺血性心肌病患者血清8-OHdG水平的影响

The effect of different dose Atorvastatin on serum 8-OHdG levels in patients with ischemic cardiomyopathy

目的探究不同剂量阿托伐他汀对缺血性心肌病患者血清8-羟脱氧鸟苷(8-OHd G)水平的影响。方法回顾性分析2015年4月至2016年3月渭南职业技术学院心内科收治的164例缺血性心肌病患者的病例资料,按照用药剂量不同分为A、B两组各82例,其中A组予以阿托伐他汀钙片治疗(辉瑞制药有限公司,规格:20 mg/片),给药方法:起始剂量为10 mg/次,1次/d,用药4周后调整给药剂量,40 mg/次,1次/d;B组予以阿托伐他汀钙片,起始剂量及用药方法同A组,待给药4周后,调整剂量为20 mg/次,1次/d。两组连续治疗6个月后,对比两组患者治疗前、后血清8-OHd G水平、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)等心功能指标及药物不良反应发生情况,并分析血清8-OHd G水平变化与LVEF的关系。结果 A组治疗后的血清8-Ohd G水平为(3.01±0.54)ng/ml,低于B组的(5.28±0.48)ng/ml(P<0.05)。A组治疗后的LVEF为(49.25±0.63)%,高于B组的(42.06±0.71)%(P<0.05)。经双变量相关分析,血清8-Ohd G水平与LVEF呈负相关(r=-0.559,P<0.05)。A、B两组药物不良反应发生率分别为12.2%、9.8%,两组比较差异无统计学意义(P>0.05)。结论 40 mg阿托伐他汀可更为有效地降低血清8-OHd G水平,以此有助于进一步改善LVEF,且增加药物剂量未见药物不良反应明显增加。

Objective To explore the effect of different dose atorvastatin on the levels of serum 8-OHdG in patients with ischemic cardiomyopathy. Methods A retrospective analysis of our hospital in recent years was performed with the clinical data of 164 patients with ischemic cardiomyopathy, and all patients were given Atorvastatin treatment, including 40 mg/time of group A, once a day, 20 mg/time of group B, twice a day. After six months＇ treatment, levels of serum 8-OHdG, cardiac function and the occurrence of adverse drug reactions were compared, and the relationship of the changes of levels of serum 8-OHdG with left ventricular ejection fraction was analyzed. Results The serum 8-OhdG level was （3.01＋0.54） ng/ml after treatment of group A, which was lower than that of group B （5.28＋0.48） ng/ml （ P 〈0.05）. The LVEF of group A after treatment was （49.25＋0.63） %, higher than that of group B （42.06＋0.71） % （ P 〈0.05）. The serum 8-OHdG level was negatively correlated with LVEF （ r =-0.559, P 〈0.05）. There was no significant difference in adverse reactions between the two groups （ P 〉0.05）. Conclusion 40 mg Atorvastatin can significantly reduce serum 8-OHdG level, which can be used to improve LVEF, and the increase of the drug dose will not increase adverse drug reactions.