瑞舒伐他汀联合曲美他嗪对冠心病合并慢性心力衰竭患者心功能及炎症反应的改善作用

Effect of rosuvastatin combined with trimetazidine on improvement of heart function and inflammation in patients with coronary heart disease and chronic heart failure

目的观察瑞舒伐他汀联合曲美他嗪对冠心病合并慢性心力衰竭患者心功能及炎症反应的影响。方法回顾性分析南京明基医院2016年1月至2017年9月确诊为冠心病合并心力衰竭94例患者临床资料,按照治疗方案不同分为联合组(n=45)和对照组(n=49)。对照组在综合治疗基础上服用瑞舒伐他汀10 mg/次,1次/d,联合组患者此基础上联合服用曲美他嗪片20 mg/次,3次/d。治疗6个月后,根据美国纽约心脏学会(NYHA)心功能分级比较2组患者的治疗效果,多普勒超声检测治疗前后血液流变学指标,ELISA法检测血清炎症因子。结果联合组的有效率显著高于对照组(91.1%vs 75.5%,P<0.05)。治疗后2组左心室射血分数(LVEF)、左室短轴缩短率(LVFS)和二尖瓣最大流速与心房收缩期血流最大流速比值(E/A)均显著改善(P<0.05),联合组改善效果显著优于对照组(P<0.05);治疗后2组血清超敏C蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)和白介素-10(IL-10)均显著下降(P<0.05),联合组改善效果显著优于对照组(P<0.05)。结论瑞舒伐他汀联合曲美他嗪可有效提升冠心病合并心力衰竭患者心功能,改善心脏血流流变学,并可降低患者体内炎症反应。

ObjectiveTo observe the effect of rosuvastatin combined with trimetazidine on heart function and inflammatory reaction in patients with coronary heart disease and chronic heart failure.MethodsClinical data of 94 patients with coronary heart disease and chronic heart failure diagnosed in Nanjing BenQ Medical Center from January 2016 to September 2017 was analyzed retro?spectively.According to different treatment options,patients were divided into combination group(n=45)and control group(n=49).The control group was given rosuvastatin on the basis of comprehensive treatment(10 mg/time,1 time/d).The combination group was given the combination of trimetazidine tablets(20 mg/time,3 times/d).After 6 months of treatment,the therapeutic effects of the two groups were compared according to the New York Heart Association(NYHA)cardiac function classification,hemorheology indexes before and after treatment with Doppler ultrasound,and serum inflammatory factors detected by ELISA.ResultsThe effective rate of the combination group was significantly higher than that in the control group(91.1%vs 75.5%,P<0.05).After the treatment,left ventricular ejection fraction(LVEF),left ventricular short axis shortening(LVFS)and mitral flow velocity ratio(E/A)were signifi?cantly improved(P<0.05).Moreover,the improvement effect of combination group was significantly better than that in the control group(P<0.05).After the treatment,serum hs-CRP,TNF-αand IL-10 were significantly decreased in two groups(P<0.05)and the improvement effect in the combination group was significantly better than that in the control group(P<0.05).Conclusion Rosuvastatin combined with trimetazidine can effectively im?prove heart function,improve cardiac rheology,and reduce inflammatory response in patients with coronary heart disease and heart failure.