阿托伐他汀联合硝普钠治疗慢性心力衰竭临床评价

Clinical Evaluation on Atorvastatin Combined with Sodium Nitroprusside in the Treatment of Chronic Heart Failure

目的探讨阿托伐他汀联合硝普钠对慢性心力衰竭(简称慢性心衰)患者血浆硫化氢(H2S)、人可溶性CD40配体(s CD40L)、降钙素基因相关肽(CGRP)、心肌肌钙蛋白I(cTnI)水平及心功能的影响。方法选取医院2014年10月至2017年6月收治的慢性心衰患者90例,按治疗方式的不同分为对照组和试验组,各45例。两组患者均给予注射用硝普钠,试验组患者加用阿托伐他汀钙片,每天1次,连续治疗5 d。结果治疗后,两组患者的H2S水平均升高,试验组为(50. 12±5. 47)μmol/L,明显高于对照组的(39. 06±5. 10)μmol/L(P <0. 05);两组患者的s CD40L,CGRP,cTnI水平均较治疗前降低,试验组s CD40L为(6. 57±1. 35) ng/m L,CGRP为(88. 28±5. 10) ng/L,c TnI为(0. 011±0. 008) ng/m L,明显低于对照组的(10. 06±1. 40) ng/m L、(100. 89±5. 50) ng/L,(0. 040±0. 016) ng/m L(P <0. 05);两组患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDd)及左室收缩末期内径(LVESd)均较治疗前改善,且试验组明显优于对照组(P <0. 05);对照组与试验组不良反应发生率相当(11. 11%比4. 44%,P> 0. 05)。结论阿托伐他汀联合硝普钠治疗慢性心衰有助于改善患者H2S,s CD40L,CGRP,cTnI水平及心功能,且安全性较好。

Objective To investigate the effect of atorvastatin combined with sodium nitroprusside on the levels of plasma hydrogen sulfide( H2 S),soluble CD40 ligand( s CD40 L),calcitonin gene-related peptide( CGRP),cardiac troponin I( cTnI) and cardiac function in patients with chronic heart failure( CHF). Methods Totally 90 patients with CHF admitted to our hospital from October 2014 to June2017 were selected and divided into the control group and the experimental group according to different treatment methods,45 cases in each group. The patients in the two groups were given Sodium Nitroprusside for Injection,on this basis,the patients in the experimental group were given Atorvastatin Calcium Tablets once a day for 5 d. Results After treatment,the level of H2 S in the two groups was increased,and that in the experimental group was( 50. 12 ± 5. 47)μmol/L,which was significantly higher than( 39. 06 ± 5. 10)μmol/L in the control group( P < 0. 05). After treatment,the levels of sCD40 L,CGRP and cTnI in the two groups were decreased,the s CD40 L,CGRP and c TnI in the experimental group were( 6. 57 ± 1. 35) ng/m L,( 88. 28 ± 5. 10) ng/L and( 0. 011 ± 0. 008) ng/m L,respectively,which were significantly lower than( 10. 06 ± 1. 40) ng/m L,( 100. 89 ± 5. 50) ng/L and( 0. 040 ± 0. 016) ng/m L in the control group( P < 0. 05). After treatment,the left ventricular ejection fraction( LVEF),left ventricular end-diastolic diameter( LVEDd) and left ventricular end-systolic diameter( LVESd) in the two groups were improved,and those in the experimental group were better than those in the control group( P < 0. 05). The incidence of adverse reactions in the experimental group was similar to that in the control group( 11. 11% vs. 4. 44%,P > 0. 05). Conclusion Atorvastatin combined with sodium nitroprusside in the treatment of CHF can improve the levels of H2 S,s CD40 L,CGRP,c TnI and cardiac function,which is safe.