阿托伐他汀对缺血性心肌病患者左室收缩功能及血浆N端脑钠肽前体水平的影响  

Effect of atorvastatin on changes of left ventricular function and plasma level of N-terminal pro-brain natriuretic peptide in ischemic cardiomyopathy patients

作　　者：翁志雄[1] 王国标[1] 刘锦光[2] 温红[3] 乐胜[1] 刘志红[1] 

机构地区：[1]广东省惠州市中心人民医院急救与创伤中心,516001 [2]广东省惠州市中心人民医院心内科,516001 [3]广东省惠州市中心人民医院超声功能科,516001

出　　处：《中国现代药物应用》2013年第20期1-3,共3页Chinese Journal of Modern Drug Application

摘　　要：目的观察阿托伐他汀对缺血性心肌病(ICM)患者左室收缩功能及血浆N端脑钠肽前体(NT-proBNP)水平的影响。方法选择ICM患者130例,随机分成阿托伐他汀治疗组(65例)和常规对照组(65例)。两组患者入选后于治疗前、治疗3个月后及治疗6个月后先后测定左室收缩末期容积(LVESV)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、心排出量(CO)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)、峰值排空率(PER)和NT-proBNP水平。结果①两组患者治疗3、6个月后LVESV、LVEDd、LVESd均较治疗前明显缩小(P<0.01),而CO、LVEF、LVFS、PER均较治疗前显著增加,两组比较差异有统计学意义(P<0.05)。两治疗组3、6个月后上述指标比较差异有统计学意义(P<0.05);其中,阿托伐他汀组治疗6个月后上述指标改善最明显(P<0.01)。②两组患者血浆NTproBNP水平在治疗3、6个月后均较治疗前明显下降(P<0.01);而两治疗组3、6个月后比较差异有统计学意义(P<0.01)。其中,以阿托伐他汀组治疗6个月下降最明显。③患者血浆NT-proBNP水平与LVESV、LVEDd、LVESd呈正相关(P<0.01),与CO、LVEF、LVFS、PER呈负相关性(P<0.01)。结论短期应用阿托伐他汀治疗可明显改善ICM患者的左室收缩功能,并有效抑制血浆NT-proBNP水平。ICM患者血浆NT-proBNP水平的改变可能早于心脏结构的变化,血浆NT-proBNP水平可作为治疗ICM患者的一个灵敏观察指标。Objective To explore the effects of atorvastatin on changes of left ventricular function and plasma level of N-terminal pro-brain natriuretie peptide in ischemic cardiomyopathy patients. Methods A total of 130 patients with ischemie cardiomyopathy were further randomly divided into control group（ n = 65 ） or atorv- astatin group（ n = 65 ）. Treatment lasted 6 months. Left ventricular end-systolic volume （LVESV）, left ventric- ular end-diastolic diameter （LVEDd）, Left ventricular end-systolic diameter （LVESd）, cardiac output （CO）, left ventrieular ejection fraction （ LVEF）, left ventrieular fractional shortening （ LVFS）, peak ejection rate （PER） of 130 patients with isehemic eardiomyopathy were examined by eehoeardiography and their plasma NT- proBNP level were measured before and after 3-months or 6-months treament. Results （!） LVESV, LVEDd, LVESd decreased after 3,6 months treatment （ P 〈 0.01 ）, but CO, LVEF, LVFS, PER improved after 3,6 months treatment（ P 〈 0.05 ） in 2 groups. There were signfieant differences between the 2 groups （ P 〈 0. 05 ）. The parameters were significantly changed in atorvastatin group after 6-months treament（ P 〈 0.01 ）. （~） The l^lasma level of NT-proBNP decreased significantly after 3-months or 6-months treatment than before treament in 2 groups （ P 〈 0.01 ）. The difference between the 2 groups of patients were statistically significant （ P 〈 0.01 ）. Among the patients, the plasma NT-proBNP in the atorvastatin group after 6-months treatment was significantly lowest （P 〈 0. 01 ）. （~_）There were positive correlations between the NT-proBNP and LVESV, LVEDd, LVESd, （ P 〈 O. 01 ）, there were negative correlation between NT-proBNP and CO,LVEF.LVFS,PER（ P 〈 0. 01 ）. Con- clusion Short-term use of atorvastatin may improve left ventrieular function and decrease the plasma NT-proB- NP in ischemie eardiomyopathy patients. The changes of NT-proBNP may be earlier than that of the paramaters and pl

关 键 词：阿托伐他汀 缺血性心肌病 左室功能 N端脑钠肽前体 

分 类 号：R542.2[医药卫生—心血管疾病]