阿托伐他汀联合法舒地尔治疗慢性肺源性心脏病心力衰竭的临床观察

Clinical Observation of Atorvastatin Combined with Faroudiel in the Therapy for Chronic Pulmonary Heart Disease with Heart Failure

目的:探讨阿托伐他汀联合法舒地尔治疗慢性肺源性心脏病心力衰竭的疗效,为临床治疗提供理论依据。方法:130例慢性肺源性心脏病合并心力衰竭患者随机分为对照组和他汀组,每组65例。对照组实施常规对症治疗,并给予法舒地尔注射液30 mg,ivd,bid。他汀组在对照组基础上加用阿托伐他汀片20 mg·d^(-1)。两组均连续治疗12周。观察两组临床疗效和药品不良反应,比较两组治疗前后动脉血氧分压(Pa O_2)、二氧化碳分压(Pa CO_2)、血氧饱和度(Sa O_2)、肺动脉收缩压(SPAP)、右心室射血分数(RVEF)、右心室Tei指数及血浆内皮素-1(ET-1)、一氧化氮(NO)、脑钠肽(BNP)水平变化。结果:他汀组治疗后总有效率为89.23%,明显高于对照组的75.38%(P<0.05)。治疗后,他汀组Pa O_2、Sa O_2、RVEF、NO较治疗前明显增高(P<0.05),Pa CO_2、BNP、SPAP、Tei指数、ET-1则较治疗前明显下降(P<0.05),且以上指标均明显优于对照组(P<0.05)。两组药品不良反应发生率差异无统计学意义(P>0.05)。结论:阿托伐他汀联合法舒地尔治疗慢性肺源性心脏病心力衰竭的疗效肯定,可有效降低患者的肺动脉压、改善右心功能。

Objective： To observe the therapeutic effects of atorvastatin combined with faroudiel on chronic pulmonary heart dis- ease with heart failure to provide theoretical basis for clinical treatment. Methods： Totally 130 cases of chronic pulmonary heart dis- ease patients with heart failure were chosen as the objects of study. The patients were randomly divided into two groups： the control group （ n = 65） and statin group （ n = 65）. The patients in the control group were treated with the routine symptomatic treatment and 30 mg faroudiel injection, bid. The patients in statin group received atorvastatin 20 mg ~ d-1 on the basis of the control group. Both groups were treated continuously for 12 weeks. The clinical efficacy and adverse drug reactions were observed in the two groups. The ar- terial blood oxygen partial pressure （ PaO2 ） , CO2 partial pressure （ PaCO2 ）, blood oxygen saturation （ Sa02 ）, pulmonary artery systol- ic pressure （ SPAP）, right ventricular ejection fraction （ RVEF）, right ventricular Tel index and plasma levels of endothelin- 1 （ ET- 1 ）, nitric oxide （NO） and brain natriuretic peptide （BNP） before and after the treatment were compared in the two groups. Results： After the treatment, the total effective rate was 89.23% in statin group, which was significantly higher than that （75.38%） in the control group, and the difference was statistically significant （ P 〈 0.05 ）. Compared with those before the treatment, PaO2, SaO2, RVEF and NO increased and PaCO2, BNP, SPAP, Tei index and ET-1 decreased in statin group （P 〈 0.05 ）. There was no statistically significant difference in the incidence of adverese drug reactions between the groups （ P 〉 0.05 ）. Conclusion： The efficacy of atorvasta- tin combined with faroudiel in the treatment of chronic pulmonary heart failure is significant, which can effectively reduce the pulmona- ry artery pressure and improve the right cardiac function.