阿托伐他汀对PCI冠心病CHF患者NT-proBNP、hs-CRP和左室重构的影响  

Changes of plasma NT-ProBNP and hs-CRP levels and relationship with left ventricular remodeling in patients treated by Atorvastatin with CHF after PCI therapy

作　　者：王大强[1] 王革新[2] 

机构地区：[1]南阳医学高等专科学校第一附属医院心血管内科,河南南阳473058 [2]南阳医学高等专科学校病原生物与免疫教研室,河南南阳473058

出　　处：《中国现代医学杂志》2012年第3期59-62,共4页China Journal of Modern Medicine

摘　　要：目的观察阿托伐他汀对经皮冠状动脉介入术(PCI)后慢性心力衰竭(CHF)患者氨基末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)和左室重构的影响及相关性。方法 122例PCI术后CHF患者(NYHA分级II/Ⅲ)随机分为阿托伐他汀20 mg组(阿托代他汀20 mg/d治疗,n=62)和阿托伐他汀他汀10㎎组(阿托伐他汀10 mg/d治疗,n=60),比较两组治疗前一般资料、两组治疗前和治疗12个月后血浆NT-proBNP和hs-CRP水平以及左室重构相关指标的变化,并分析其相关性。结果两组治疗后血浆NT-proBNP和hs-CRP水平均较治疗前显著降低(P<0.05),治疗后阿托伐他汀20 mg组血浆NT-proBNP和hs-CRP水平显著低于阿托伐他汀10 mg组(P<0.05)。阿托伐他汀治疗后,两组左室舒张末期内径(LVEDD)较治疗前均显著降低(P<0.05),两组左室射血分数(LVEF)较治疗前均显著升高(P<0.05),阿托伐他汀20 mg组左室舒张末期内径(LVEDD)显著小于阿托伐他汀10 mg组(P<0.05);阿托伐他汀20 mg组LVEF显著大于阿托伐他汀10 mg组(P<0.05)。两组治疗前后血浆NT-proBNP和hs-CRP的下降水平均与LVEDD减少呈正相关,与LVEF增加呈负相关;NT-proBNP、hs-CRP下降水平两者呈正相关(均P<0.05)。结论阿托伐他汀对PCI冠心病CHF患者心功能改善有益,且与药物剂量有关。[ Objective ] To investigate the effects of atorvastatin on N-terminal pro-brain natriuretic peptide （NT-ProBNP） and high sensitive C reactive protein （hs-CRP） as well as left ventrieular remodeling in patients with chronic heart failure （CHF） after percutaneous coronary intervention （PCI）. [Methods] A total of 122 CHF （Ⅰ/Ⅲ of NYHA Classification） patients who received PCI were randomized to atorvastatin 20 mg/day （n =62） and atorvastatin 10 rag/day （n =60）. Before and after 12 months treatment, cardiac function was evaluated by echocardiography, and the plasma levels of NT-proBNP and hs-CRP were examined by flow cytometric analysis and enzyme-linked im- muno sorbent assay （ELISA）. [ Results ] Baseline data were similar between the two groups. NT-proBNP, hs-CRP and LVEDD were decreased while LVEF was increased in both therapy group after 12 months compared with those pre-therapy （P 〈0.05, respectively）. The levels of NT-proBNP, hs-CRP and LVEDD to those in the atorvastatin 10 mg/day group were significantly reduced in the atorvastatin 20 mg/day group （380.4±56.7vs. 320.3±98.2, 1.7±0.2 vs.1.2±0.3, 39±10 vs. 37±11, respectively; P 〈0.05）. But LVEF was conspicuously higher in the atorvastatin 20 mg/day group than those in the atorvastatin 10 mg/day group （44±3 vs. 41±2, respectively; P 〈0.05）. The expression of NT- proBNP and hs-CRP was positively correlated with each other （r =0.74, P 〈0.05） and with the LVEDD （r =0.66 and r =0.71, respectively; P 〈0.05）. But they were negatively correlated with the LVEF （r =-0.78 and r =-0.63, respectively; P 〈0.05）. [ Conclusion] Atorvastatin had beneficial effects on cardiac function for CHD patients who treated with PCI.

关 键 词：阿托伐他汀 氨基末端脑钠肽前体 超敏C反应蛋白 左室重构 

分 类 号：R972[医药卫生—药品] R541[医药卫生—药学]