阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响

Influence of atorvastatin on levels of NT-proBNP, oxidative stress in patients with chronic heart failure

目的探讨阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响。方法选择2015年9月—2017年2月非缺血性心脏病慢性心衰患者102例,将所有患者随机分为对照组(n=51)和阿托伐他汀组(n=51)。对照组实施常规抗心衰药物治疗,阿托伐他汀组在常规抗心衰治疗基础上加用阿托伐他汀治疗,20 mg/d。两组疗程均为24周。观察并比较两组治疗前后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、NYHA分级、左室射血分数(LVEF)、NT-proBNP、6 min步行距离(6MWT)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、丙二醛(MDA)等指标。结果阿托伐他汀组治疗后TG、TC、LDL-C水平明显下降,与治疗前及对照组比较,差异均有统计学意义(P<0.05)。两组患者治疗后NT-proBNP水平均有明显下降,与治疗前比较,差异有统计学意义(P<0.05),但阿托伐他汀组下降幅度优于对照组,组间比较差异有统计学意义(P<0.05)。与同组治疗前及对照组比较,阿托伐他汀组治疗后SOD明显增高,MDA、MPO明显下降,差异均有统计学意义(P<0.05);而对照组治疗前后无明显变化。结论在常规抗心衰治疗的基础上加用阿托伐他汀,能有效降低CHF患者的NT-proBNP水平和抑制患者的氧化应激状态。

Objective To explore the influence of atorvastatin on N-terminal brain natriuretic peptide（NT-pro BNP） and oxidative stress in patients with chronic heart failure（CHF）. Methods 102 cases of chronic heart failure patients with non-ischaemic heart disease were chosen as chosen as the research objects. The patients were randomly divided into control group（n = 51） and atorvastatin group（n = 51）. The patients were treated with the conventional drugs in control group, and combined with atorvastatin of 20 mg/d in atorvastatin group. All patients were treated for 12 weeks. Triglyceride（TG）, total cholesterol（TC）, high-density lipoprotein（HDL-C）, low density lipoprotein（LDL-C）, NYHA classification, left ventricular ejection fraction（LVEF）, NT-pro BNP, 6 min walking distance（6 MWT）, SOD, MPO, MDA were observed and compared before and after treatment in two groups. Results Compared with before treatment and control group, TG, TC, LDL-C decreased obviously after treatment in atorvastatin group, the differences were statistically significant（P〈0.05）. NT-pro BNP levels decreased significantly after treatment in two groups, compared with that before treatment, the differences were statistically significant（P〈0.05）, but the change in atorvastatin group was better than that in control group（P〈0.05）. Compared with those before treatment and control group, SOD increased significantly, MDA, MPO decreased significantly after treatment in atorvastatin group, the differences were statistically significant（P〈0.05）. The control group had no significant change before and after treatment. Conclusion The conventional anti-heart failure treatment added with atorvastatin could reduce effectively NT-pro BNP level and inhibit oxidative stress in CHF patients.