阿托伐他汀对射血分数保留心力衰竭患者的临床疗效  

Clinical study of atorvastatin in patients with heart failure of preserved ejection fractionClinical study of atorvastatin in patients with heart failure of preserved ejection fraction

作　　者：李博 朱平先[2] 吴清华[3] 

机构地区：[1]深圳市南澳人民医院内科,广东省518121 [2]深圳市龙岗区人民医院心内科 [3]南昌大学第二附属医院心内科

出　　处：《中国心血管病研究》2011年第1期49-51,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的观察阿托伐他汀对射血分数保留的心衰（HFPEF）的疗效。方法将82例HFPEF患者随机分为对照组和阿托伐他汀组。对照组给予基础治疗（包括血管紧张素转换酶抑制剂、利尿剂和B受体阻断剂）；阿托伐他汀组在此基础上口服阿托伐他汀（立普妥20mg，qn）。在治疗前和随访18个月后检测左室质量指数（LVMI）、左房容积指数（LAVI）、血浆N末端脑利钠肽（NT—proBNP）及高敏C反应蛋白（hs—CRP）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-2（MMP-2）水平，评价NHYA心功能，测定6min步行距离。结果与对照组治疗后相比，阿托伐他汀组NYHA心功能分级下降，6min步行距离延长，NT—proBNP、hs—CRP、TNF—α及MMP-2水平下降，LVMI值及LAVI值降低，差异有统计学意义。结论阿托伐他汀通过抑制心脏重构、减轻炎症反应、提高运动耐量、改善症状而对HFPEF患者有益，但仍需更多的临床研究进一步证实。Objective To observe the effects of atorvastatin on patients with heart failure of preserved ejection fraction （HFPEF）. Methods 82 patients with HFPEF were randomly divided into two groups： control group was given angiotensin-converting enzyme inhibitors （ACEI）, diuretic drugs, β-receptor blockers, while the atorvastatin group was treated with additional atorvastatin （20 mg qn）. Before treatment and after 18 months they were followed up, and the left ventricle material index（LVMI）, left artial volume index （LAVI）, serial N terminal proB-type natriuretic peptide（NT-proBNP）, high sensitivity C reaction protein （hs-CRP）, tumor necrosis factor- α （TNF-α） and matrix metalloproteinase-2 （MMP-2）, heart function of NYHA and 6 minute walk test（6MWT） were measured and evaluated. Results Compared with control group after treatment, NYHA class grade decreased and 6MWT extended in atorvastatin group, meanwhile, the levels of NT-proBNP, hs-CRP, TNF-α, MMP-2, LVMI and LAVI reduced, P〈0.05. Conclusion Atorvastatin can improve endurance exercise, resist heart remodeling and inflammatory reaction in patients with heart failure of preserved ejection fraction（HFPEF）, but further clinical study will he needed to prove.

关 键 词：心力衰竭 射血分数保留 阿托伐他汀 左室质量指数 左房容积指数 6 MIN步行试验 

分 类 号：R541.6[医药卫生—心血管疾病]