慢性心力衰竭患者应用不同剂量阿托伐他汀治疗的临床研究

Different doses of atorvastatin for the treatment of chronic heart failure in patients

目的:探讨应用不同剂量阿托伐他汀治疗慢性心力衰竭的临床效果。方法:收集2019年6月至2020年6月蚌埠医学院附属蚌埠市第三人民医院收治的慢性心力衰竭患者100例,采用随机数字表法分为对照组(慢性心力衰竭常规治疗+阿托伐他汀钙片10 mg)49例和观察组(慢性心力衰竭常规治疗基础上+阿托伐他汀钙片20 mg)51例,比较两组患者治疗前和治疗12周后N-末端脑利钠肽前体(NT-proBNP)和炎性细胞因子如血清超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、白细胞介素10(IL-10)以及心脏重构(超声心动图指标)的结果。结果:治疗后,观察组与对照组的NT-proBNP分别为(506.56±62.37)pg/mL与(660.85±74.55)pg/mL,hs-CRP分别为(14.74±2.69)mg/L与(23.31±3.45)mg/L,IL-6分别为(36.77±4.78)ng/L与(43.12±5.22)ng/L,IL-10分别为(12.36±2.63)ng/L与(15.39±3.56)ng/L,左心室舒张末期内径(LVEDD)分别为(37.74±6.83)mm与(42.36±7.73)mm,左室射血分数(LVEF)分别为(45.78±3.31)%与(42.63±2.56)%,舒张末期最大流量比(E/A)分别为(1.44±0.06)与(1.21±0.03),两组差异均有统计学意义(t=3.73、3.07、3.58、3.68、2.99、3.12、2.98,均P<0.05)。结论:应用阿托伐他汀有利于慢性心力衰竭患者的预后,每天20 mg阿托伐他汀治疗比每天10 mg效果更好。

Objective To investigate the clinical efficacy of different doses of atorvastatin in the treatment of chronic heart failure.Methods A total of 100 patients with chronic heart failure who received treatment in the Third People's Hospital of Bengbu Medical College from June 2019 to June 2020 were included in this study.They were randomly divided into a control group(conventional treatment+atorvastatin calcium tablet 10 mg,n=49)and an observation group(conventional treatment+atorvastatin calcium tablet 20 mg,n=51).Before and after 12 weeks of treatment,serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP)and inflammatory cytokines such as high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-10(IL-10)as well as ventricular remodeling(echocardiographic index)were compared between the two groups.Results After treatment,serum level of NT-proBNP was(506.56±62.37)pg/mL and(660.85±74.55)pg/mL,serum level of hs-CRP was(14.74±2.69)mg/L and(23.31±3.45)mg/L,serum level of IL-6 was(36.77±4.78)ng/L and(43.12±5.22)ng/L,serum level of IL-10 was(12.36±2.63)ng/L and(15.39±3.56)ng/L,left ventricular end diastolic diameter was(37.74±6.83)mm and(42.36±7.73)mm,left ventricular ejection fraction was(45.78±3.31)%and(42.63±2.56)%,and the ratio of early(E wave)to late(A wave)diastolic velocities(E/A)was(1.44±0.06)and(1.21±0.03),respectively in the observation and control groups.There were significant differences in serum levels of NT-proBNP,hs-CRP,IL-6 and IL-10 as well as LVEDD and LVEF between the observation and control groups(t=3.73,3.07,3.58,3.68,2.99,3.12 and 2.98,all P<0.05).Conclusion Atorvastatin is beneficial to the prognosis of patients with chronic heart failure.The therapeutic efficacy of 20 mg atorvastatin per day is better than that of 10 mg atorvastatin per day.