加倍剂量的瑞舒伐他汀对老年慢性心力衰竭患者心功能和氧化应激反应程度的影响及用药安全性分析

Study on effect and safety of double-dosage rosuvastatin on heart function and oxidative stress in treatment of elderly patients with chronic heart failure

目的分析加倍剂量的瑞舒伐他汀对老年慢性心力衰竭患者心功能、氧化应激反应程度的影响及用药安全性。方法前瞻性选取2014年3月至2018年2月海南医学院第一附属医院心内科收治的老年慢性心力衰竭患者166例,按随机数字表法将患者分为对照组(n=83)和观察组(n=83)。所有患者均给予瑞舒伐他汀和常规治疗,观察组瑞舒伐他汀用量为20 mg/次,对照组用量为5 mg/次。观察并比较两组患者的临床疗效、心功能指标、氧化应激反应指标以及不良反应等。结果观察组总有效率(91.6%)明显高于对照组(78.3%),差异具有统计学意义(P <0.05)。两组患者在治疗前的心功能各项指标差异无统计学意义(P> 0.05),观察组患者在治疗后的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)低于对照组,而左室射血分数(LVEF)、A峰E峰流速比值(E/A)高于对照组,差异具有统计学意义(P <0.05)。治疗前,两组患者的氧化应激反应指标差异无统计学意义(P> 0.05);观察组患者在治疗后的髓过氧化物酶(MPO)和丙二醛(MDA)均低于对照组,而超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)均高于对照组,差异具有统计学意义(P <0.05)。两组患者的不良反应发生率差异无统计学意义(P> 0.05)。结论 20 mg加倍剂量的瑞舒伐他汀治疗老年慢性心力衰竭患者的临床疗效显著,能有效改善患者的心功能,可抑制机体氧化应激反应水平,不会产生较大的不良反应,用药安全性好,值得在临床上推广使用。

Objective To analyze the effect and safety of double-dosage rosuvastatin on heart function and oxidative stress in treatment of elderly patients with chronic heart failure(CHF).Methods Prospectively selected 166 elderly patients with chronic heart failure during March 2014 to February 2018 in the Department of Cardiology,First Affiliated Hospital of Hainan Medical College were divided into control group(n=83)and observation group(n=83)according to random digitized table method.All patients were given with rosuvastatin and routine treatment,The dosage of rosuvastatin in observation group were 20 mg/time,and the dosage of rosuvastatin in control group was 5 mg/time.The clinical efficacy,cardiac function,oxidative stress and adverse reactions were observed and compared between these two groups.Results The total effective rate of control group was 78.3%,while that of observation group was 91.6%.The total clinical effective rate of control group was significant lower than that of observation group(P<0.05).There was no significant difference in indexes of cardiac function between these two groups before treatment(P>0.05).The level of left ventricular end-diastolic dimension(LVEDD)and left ventricular end systolic diameter(LVESD)in observation group were significantly lower than those of control group,while the level of left ventricular ejection fraction(LVEF)and the ratio of E and A velocity(E/A)were significantly higher than those of control group(P<0.05).There was no significant difference in indexes of oxidative stress between these two groups before treatment(P>0.05);the level of myeloperoxidase(MPO)and malondialdehyde(MDA)of observation group after treatment were significantly lower than those of control group,while the level of superoxide dismutase(SOD)and glutathion peroxidase(GSH-Px)were significantly higher than those of control group(P<0.05).There was no significant difference in adverse reactions between these two groups(P>0.05).Conclusion The clinical efficacy of application of double dosage(20 mg)of rosuvastatin in treatment of elderly patients with chronic heart failure is significant,it can effectively improve the heart function of patients,it can inhibit the level of oxidative stress in patients with no major adverse reaction,the safety of drug is good,hence it is worthy to be clinically promoted and applied.