辛伐他汀联合曲美他嗪治疗老年慢性心力衰竭的临床疗效及其对患者心功能和炎性因子的影响

Clinical effect of simvastatin combined with trimetazidine in the treatment of elderly chronic heart failure and the impact on cardiac function and inflammatory factor

目的探讨辛伐他汀联合曲美他嗪治疗老年慢性心力衰竭的临床疗效及其对患者心功能、炎性因子的影响。方法选取泗阳县人民医院2015年3月—2016年3月收治的老年慢性心力衰竭患者70例,根据不同治疗方法分为对照组和研究组,各35例。患者入院后均给予常规对症治疗,对照组患者给予盐酸曲美他嗪片治疗,研究组患者在对照组基础上给予辛伐他汀治疗,两组患者均连续治疗12周。比较两组患者临床疗效、治疗前后心功能指标〔左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)〕、6min步行距离、血清炎性因子〔超敏C反应蛋白(hs-CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、脑钠肽(BNP)〕水平,并观察比较两组患者不良反应发生情况。结果研究组患者总有效率高于对照组(P<0.05)。治疗前,两组患者LVEDD、LVESD、LVEF、6min步行距离比较,差异无统计学意义(P>0.05);治疗后,研究组患者LVEDD、LVESD低于对照组,LVEF高于对照组,6min步行距离长于对照组(P<0.05)。治疗前,两组患者血清hs-CRP、IL-6、TNF-α及BNP水平比较,差异无统计学意义(P>0.05);治疗后,研究组患者血清hs-CRP、IL-6、TNF-α及BNP水平低于对照组(P<0.05)。两组患者均未见严重不良反应发生。结论辛伐他汀联合曲美他嗪治疗老年慢性心力衰竭患者临床疗效确切,可有效改善患者心功能,减少炎性反应,且安全性好。

Objective To discuss the clinical effect of simvastatin combined with trimetazidine in the treatment of elderly chronic heart failure and the impact on cardiac function and inflammatory factor. Methods A total of 70 cases of elderly chronic heart failure patients were selected from March 2015 to March 2016 in People' s Hospital of Siyang County,which were divided into control group and study group according to different treatment,35 cases in each group. Patients were given conventional symptomatic treatment,control group of patients were treated with trimetazidine dihydrochloride tablets,study group of patients were treated with simvastatin on the basis of control group,all patients were treated for 12 weeks. The clinical effect,cardiac function index( LVEDD, LVESD, LVEF) and 6min walking distance, inflammatory factor( hs-CRP, IL-6,TNF-α,BNP) before and after treatment were compared between the two groups,and the adverse reactions were compared between the two groups. Results The total clinical effective rate of study group was higher than control group( P < 0. 05).Before treatment,there was no statistically significant differences of LVEDD,LVESD,LVEF and 6min walking distance between the two groups( P > 0. 05); after treatment,the study group of LVEDD,LVESD were lower than control group,LVEF was higher than control group,6min walking distance was longer than control group( P < 0. 05). Before treatment,there was no statistically significant differences of hs-CRP,IL-6,TNF-α,BNP between the two groups( P > 0. 05); after treatment,the study group of hs-CRP,IL-6,TNF-α,BNP were lower than control group( P < 0. 05). No adverse reactions was happened. Conclusion It has an obviously clinical effect of simvastatin combined with trimetazidine in the treatment of elderly chronic heart failure,can effectively improve cardiac function of patients and reduce the inflammatory reactions,and with good safety.