不同剂量阿托伐他汀对冠心病患者心功能、血脂及血清TNF-α、ANF水平的影响

Effects of Different Doses of Atorvastatin on Cardiac Function,Blood Lipids and Serum TNF-α and ANF Levels in Patients with Coronary Heart Disease

目的:探讨不同剂量阿托伐他汀对冠心病患者心功能、血脂及血清肿瘤坏死因子-α(TNF-α)、心钠素(ANF)水平的影响。方法:选取2016年1月到2017年1月在我院接受治疗的冠心病患者86例,根据随机数字表法将患者分为观察组和对照组,各43例,对照组给予10 mg剂量的阿托伐他汀进行治疗,观察组给予20 mg剂量的阿托伐他汀进行治疗,两组均治疗6个月。比较两组患者治疗前后的左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心房前后径(LAD)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TNF-α、ANF水平。对所有患者进行1年的随访,比较患者出现心肌梗死、心律失常、心源性死亡等心血管事件的情况。结果:治疗后两组的LVEDD、LAD、TC、TG、LDL-C、TNF-α、ANF均显著降低,LVEF、HDL-C显著升高(P<0.05),治疗后观察组的LVEDD、LAD、TC、TG、LDL-C、TNF-α、ANF低于对照组,LVEF高于对照组(P<0.05)。两组的心血管事件发生率比较无统计学差异(P>0.05)。结论:两种剂量的阿托伐他汀均能有效的改善冠心病患者的心功能和血脂,降低患者体内的炎症反应,但20 mg剂量的阿托伐他汀效果更佳。

Objective: To investigate the effects of different doses of atorvastatin on cardiac function, blood lipids and serum tumor necrosis factor-α(TNF-α) and atrial natriuretic factor(ANF) levels in patients with coronary heart disease. Methods: 86 cases of coronary heart disease treated in our hospital from January 2016 to January 2017 were selected. The patients were divided into observation group and control group according to the random number table method, 43 cases in each group. The control group was treated with 10 mg dosage of atorvastatin, while the observation group was treated with 20 mg dosage of atorvastatin. The two groups were treated for 6 months. The levels of left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), left atrium anteroposterior diameter(LAD), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), TNF-α and ANF were compared between the two groups before and after treatment. All patients were followed up for one year to compare the occurrence of cardiovascular events such as myocardial infarction, arrhythmia and cardiac death. Results: After treatment, the levels of LVEDD, LAD, TC, TG, LDL-C, TNF-α and ANF in both groups were significantly decreased, while the levels of LVEF and HDL-C were significantly increased(P<0.05). After treatment, the levels of LVEDD, LAD, TC,TG, LDL-C, TNF-α and ANF in the observation group were lower than those in the control group, and the level of LVEF in the observation group was higher than that in the control group(P <0.05). There was no significant difference in the incidence of cardiovascular events between the two groups(P>0.05). Conclusion: Both doses of atorvastatin can effectively improve heart function and blood lipids in patients with coronary heart disease, reduce the inflammatory reaction in patients, but the effect of 20 mg of atorvastatin is better.