他汀类药物治疗慢性心力衰竭的疗效及预后影响研究  

The therapeutic and prognostic effect of statins on chronic heart failure

作　　者：苏倩[1] 吴穷[1] 柴熙晨[1] 李金平[1] 应晨[1] 潘文麒[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院心内科,上海200025

出　　处：《内科理论与实践》2013年第1期45-48,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的：评价他汀类药物对慢性心力衰竭（CHF）患者疗效和预后的影响。方法：自2010年1月起共入选了我院、卢湾区中心医院及闵行区中心医院确诊的240例纽约心功能分级Ⅱ~Ⅳ级慢性收缩性心力衰竭患者[左心室射血分数（LVEF）≤45%],按照患者是否用他汀类药物治疗分为治疗组和对照组,每组各120例,比较2组患者治疗前后血脂、血清氨基末端脑钠肽前体（NT-proBNP）、炎症因子高敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）的变化,以及心脏超声监测心腔大小及LVEF变化。观察2组患者的生存率及终点事件发生率。结果：与对照组相比,治疗组血脂水平及血清NT-proBNP、hs-CRP、TNF-α水平降低（P〈0.001）;心腔缩小,LVEF有所提高（41.5%比42.8%,P=0.034）。治疗组患者生存率较对照组高（92.5%比80.8%,P=0.013）,复合终点事件发生率降低（38.3%比57.5%,P=0.006）。结论：他汀类药物能降低CHF患者的血脂水平、预后因子NT-proBNP和炎症因子的水平,能使CHF患者心腔缩小,从而提高CHF患者的LVEF和生存率,降低复合终点事件发生率,能改善CHF患者的预后。Objective To evaluate the therapeutic and prognostic effect of statins in patients with chronic heart failure （CHF）. Methods A total of 240 heart failure patients with New York Heart Association （NYHA） Class Ⅱ-Ⅳ[left ventrieular ejection fraction （LVEF ≤45%）] from our hospital, Lu Wan District Central Hospital and Min Hang District Central Hospital were enrolled in this study. Patients were assigned into two group with 120 patients each according to whether statins was taken or not. The changes of cholesterol level, serum N-terminal probrain natriuretie peptide （NT- proBNP）, high sensitive C reactive protein （hs-CRP）, tumor necrosis factor-alpha （TNF-α）, and the differences of LVEF and eardiae ehamber size by eehoeardiography monitoring before and after treatment were eompared between the two groups. Furthermore, the survival rate and endpoint event rate were eompared. Results As eompared with non-statins group, serum NT-proBNP, hs-CRP and TNF-α were decreased signifieantly in statins group, while LVEF was increased （41.5% vs 42.8%, P=0.034） and cardiac chamber size was reduced. Survival rate increased （92.5% vs 80.8%, P=0.013） and end point event rate decreased in statins group （38.3% vs 57.5%, P=0.006）. Conclusions CHF patients treated with statins had a lower serum cholesterol, NT-proBNP, hs-CRP and TNF-α level and reduced eardiae chamber size, but higher LVEF and survival rate and fewer endpoint events, suggesting that statins eould improve the prognosis of CHF.

关 键 词：慢性心力衰竭 羟甲基戊二酸辅酶A还原酶抑制剂 生存率 终点事件 

分 类 号：R541.6[医药卫生—心血管疾病]