阿托伐他汀钙联合左西孟旦治疗射血分数保留型慢性心力衰竭患者的疗效评价

Efficacy Evaluation of Atorvastatin Calcium Combined with Levosimendan in the Treatment of Patients with Chronic Heart Failure with Preserved Ejection Fraction

目的:分析阿托伐他汀钙联合左西孟旦治疗射血分数保留型慢性心力衰竭(HF-PEF)患者的疗效。方法:选取2018年3月—2019年6月焦作煤业(集团)有限责任公司中央医院收治的75例HF-PEF患者,根据随机数表法分为观察组和对照组。对照组37例,接受左西孟旦治疗,观察组38例,接受阿托伐他汀钙联合左西孟旦治疗,比较两组患者疗效、治疗前后心室重构情况[左心房质量指数(LVMI)、舒张早期血流峰速度减速时间(DT)、左心房容积指数(LAVI)、舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A)]、无创血流动力学[心输出量(CO)、心脏指数(CI)、心缩力指数(HI)]、血清炎性因子水平[基质金属蛋白酶9(MMP-9)、肿瘤坏死因子-α(TNF-α)、几丁质酶3样蛋白1(CHI3L1)、超敏C反应蛋白(hs-CRP)]。结果:两组患者治疗总有效率对比,观察组(92.11%)较对照组(67.57%)高。治疗后,两组患者心室重构均得到改善,且与对照组对比,观察组LVMI、DT、LAVI较低,E/A较高,差异有统计学意义(t=9.370、3.537、4.231、5.230,P<0.05)。治疗后,两组患者无创血流动力学水平均提升,且观察组CO、CI、HI水平均较对照组高,差异有统计学意义(t=5.280、7.261、10.412,P<0.05)。治疗后,两组患者血清炎性因子水平均降低,且观察组血清MMP-9、TNF-α、CHI3L1、hs-CRP水平较对照组低,差异有统计学意义(t=20.040、16.402、75.853、2.766,P<0.05)。结论:阿托伐他汀钙联合左西孟旦治疗HF-PEF,效果显著,能有效抑制心室重构,改善无创血流动力学,降低炎性因子水平。

Objective:To analyze the efficacy of atorvastatin calcium combined with levosimendan in the treatment of patients with chronic heart failure with preserved ejection fraction(HF-PEF).Methods:A total of 75 HF-PEF patients in the hospital(from March 2018 to June 2019)were selected and divided into the observation group and the control group according to the random number table method.37 cases in the control group received levosimendan treatment,and 38 cases in the observation group received atorvastatin calcium combined with levosimendan treatment.The efficacy,ventricular remodeling before and after treatment(left atrial mass index[LVMI],deceleration time of peak blood flow velocity in early diastole[DT],left atrial volume index[LAVI],mitral valve blood flow velocity in early diastole and late diastolic blood flow velocity Mitral valve blood flow velocity ratio[E/A]),noninvasive hemodynamics(cardiac output[CO],cardiac index[CI],inotropic index[HI]),serum inflammatory factor levels(matrix metal Protease 9[MMP-9],tumor necrosis factor-α[TNF-α],chitinase 3-like protein 1[CHI3L1],and high-sensitivity C-reactive protein[hs-CRP])of the two groups were compared.Results:The total effective rate(92.11%)of the observation group was higher than that of the control group(67.57%).After treatment,ventricular remodeling was improved in both groups,and compared with the control group,the observation group had lower LVMI,DT,and LAVI,and higher E/A,the difference was statistically significant(t=9.370,3.537,4.231,5.230,P<0.05).After treatment,the non-invasive hemodynamic levels in both groups were improved,and the levels of CO,CI and HI in the observation group were higher than those in the control group,the difference was statistically significant(t=5.280,7.261,10.412,P<0.05).After treatment,the levels of serum inflammatory factors in both groups were decreased,and the levels of serum MMP-9,TNF-α,CHI3L1 and hs-CRP in the observation group were lower than those in the control group,the difference was statistically significant(t=20.040,16.402,75.853,2.766,P<0.05).Conclusion:Atorvastatin calcium combined with levosimendan in the treatment of HF-PEF has a significant effect,can effectively inhibit ventricular remodeling,improve noninvasive hemodynamics,and reduce the level of inflammatory factors.