调脂治疗对慢性心力衰竭患者炎症反应及左室功能的影响  

Influnce of lipid-lowing therapy on inflammatory response and left ventricular diastolic function in patients with chronic heart failure

作　　者：祝炜[1] 郑琼莉[1] 戴旭辉 周军[1] 戴榕[1] 刘娟[1] 

机构地区：[1]武汉市第一医院心内科,武汉430022 [2]不详

出　　处：《临床心血管病杂志》2014年第6期480-483,共4页Journal of Clinical Cardiology

基　　金：武汉市卫生局科研项目(No:武卫[2009]76号WX09A02)

摘　　要：目的:观察在标准抗心力衰竭(心衰)药物治疗基础上加用他汀类调脂药物,患者炎性细胞因子、左室射血分数(LVEF)及运动耐量等指标变化,探讨调脂治疗抑制炎症反应、改善心衰患者心脏功能的可能机制。方法:将入选的慢性心衰患者随机分为标准治疗+调脂治疗组(治疗组)和标准治疗组(对照组),均于治疗前后进行血液分析、血脂分析、肝功能、肾功能、电解质分析及心电图等常规检查。6个月后,检测并比较两组患者炎性细胞因子、心脏功能及运动耐量和安全性指标。结果:与治疗前比较,两组患者LVEF均有一定改善,但差异无统计学意义,两组间比较差异亦无统计学意义;两组运动耐量均有提高(P<0.05),治疗组提高程度略优于对照组,但差异无统计学意义;两组炎性细胞因子浓度降低(P<0.01),治疗组下降幅度优于对照组(P<0.01);对照组治疗前后血脂水平差异无统计学意义,治疗组治疗后均明显降低,且低于对照组治疗后(均P<0.01)。结论:调脂治疗在标准抗心衰治疗的基础上,能进一步抑制炎症反应,但对改善慢性心衰患者的心功能和运动耐量与标准抗心衰治疗无差异。Objective：To discuss the possible mechanism that lipid-lowing therapy inhibit inflammation and im- prove the heart function in patients with heart failure. Method： All 122 selected chronic heart failure patients were randomly divided into observation group who were treated with standard western medicine and lipid-lowing thera-py, and control group who were treated with standard western medicine only. Hemanalysis, urinalYsis, electrolyt- ic analysis, liver fuction, renal function and ECG were observed respectively before and after the treatment. Six months later, inflammatory cytokines, LVEF, exercise tolerance and safety index were contrastly analysed. Re- suit：Compared with those before treatment, the improvement of LVEF in two groups after treatment were not sig- nificant; exercise tolerancein two groups all improved （both P〈0.05） and the improvement in observation group was slightly significant; inflammatory cytokines all reduced （both P〈0.05）, and more significant in observation group （P〈0.05） ; blood lipid level in observation group was lower than that before treatment （P〈0.01）, while there was no significantly difference before or after treatment in control group. Conclusion.. Lipid-lowing therapy has a futher fuction on inflammation inhibition, but in patients with chronic heart failure, there is no difference compared with standard anti heart failure treatment in improveing cardiac function and exercise tolerance.

关 键 词：慢性心力衰竭 调脂治疗 炎症反应 左室功能 

分 类 号：R541.6[医药卫生—心血管疾病]