不同剂量阿托伐他汀治疗早期心肾综合征的疗效比较  

Efficacy Analysis of Different Doses of Atorvastatin in the Treatment of Early Cardiorenal Syndrome

作　　者：姚建华[1] 陈德[1] 马瑾[1] 王蕊[1] 王渊铭[1] 王豪[1] 邵彩红[2] 许嘉鸿[3] 

机构地区：[1]同济大学附属杨浦医院心内科,上海200090 [2]同济大学附属东方医院急诊内科,上海200120 [3]同济大学附属同济医院心内科,上海200440

出　　处：《中国临床医学》2015年第3期349-352,共4页Chinese Journal of Clinical Medicine

基　　金：同济大学附属杨浦医院基金项目(编号:SE1201214);上海市卫生局项目(编号:20124Y103)

摘　　要：目的:观察不同剂量阿托伐他汀对慢性心力衰竭引起的早期心肾综合征的疗效。方法:选择90例慢性心力衰竭引起的早期心肾综合征患者,随机分为常规治疗组(A组)、阿托伐他汀20 mg组(B组)、阿托伐他汀40 mg组(C组),各30例。A组给予常规抗心衰药物治疗,B组和C组在常规抗心衰药物治疗基础上分别口服阿托伐他汀20 mg/d、40 mg/d。测量3组治疗前及治疗3个月、6个月后血清肌酐(serum creatinine,Scr)浓度、肾小球滤过率(glomerular filtration rate,GFR)、左室射血分数(left ventricular ejection fraction,LVEF)、血超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)浓度等,并进行组间比较。结果:3组治疗3个月、6个月后LVEF均较治疗前增加,差异有统计学意义(P<0.05、P<0.01),但3组间差异无统计学意义(P>0.05)。治疗3个月后,A组、B组的Scr及GFR与治疗前比较差异均无统计学意义(P>0.05);C组Scr及GFR均较治疗前改善,差异有统计学意义(P<0.05);3组间Scr及GFR差异无统计学意义(P>0.05)。治疗6个月后,A组Scr、GFR与治疗前差异无统计学意义(P>0.05);B组、C组Scr、GFR较治疗前改善,差异均有统计学意义(P<0.01);C组治疗6个月后Scr、GFR较治疗3个月后改善,差异有统计学意义(P<0.01);治疗6个月后,B组、C组Scr与A组差异有统计学意义(P<0.05、0.01),C组Scr与B组差异有统计学意义(P<0.05),C组GFR与A组差异有统计学意义(P<0.05)。A组hs-CRP治疗前后差异无统计学意义(P>0.05);B组、C组治疗3个月及6个月后hs-CRP均较治疗前降低,差异有统计学意义(P<0.01);C组治疗6个月后hs-CRP与治疗3个月后差异有统计学意义(P<0.01);B组、C组治疗6个月后hs-CRP与A组差异有统计学意义(P<0.05、0.01),同时,B组和C组间hs-CRP差异有统计学意义(P<0.05)。结论:在常规治疗的基础上加用阿托伐他汀可明显改善肾功能,其机制可能与阿托伐他汀能够控制炎性反应有关;阿托伐他汀对肾功能的Objective：To observe the efficacy of different doses of atorvastatin on the early cardiorenal syndrome caused by chronic heart failure.Methods：A total of 90 patients with early cardiorenal syndrome caused by chronic heart failure were randomly divided into conventional treatment group（group A）,atorvastatin 20 mg group（group B）and atorvastatin 40 mg group（group C）,with 30 patients in each group.The patients in group A received therapy of conventional anti-heart failure agent,the patients in group B and group C orally received atorvastatin20 mg/d,40 mg/d respectively,based on the therapy of conventional anti-heart failure agent.Serum creatinine（Scr）and glomerular filtration rate（GFR）,left ventricular ejection fraction（LVEF）and high sensitivity C-reactive protein（hs-CRP）of patients in the three groups,were detected,before the treatment,after 3months of treatment,and after 6 months of treatment.And the data were compared among the groups.Results：After 3 months or 6 months of treatment,levels of LVEF in 3 groups were higher than that before treatment（P〈0.05,0.01）.There was no significant difference among the 3 groups（P〈0.05）.There was no significant difference between the levels of Scr and GFR in group A or group B after 3 months of treatment and those before treatment（P〈0.05）.The levels of Scr and GFR in group C after 3 months of treatment were improved,while compared with those before treatment,and the differences showed statistically significant（P〈0.05）.There was no significant difference among the 3 groups（P〈0.05）.There was no significant difference between the levels of Scr and GFR in group A After 6 months of treatment and that before treatment（P〈0.05）.The levels of Scr,GFR in group B and group C significantly improved after 3 months of treatment,while compared with those before treatment（P〈0.01）.The levels of Scr and GFR in group C after 6 months of treatment,improved significantly,while compared with that after 3 months of treatment（

关 键 词：心肾综合征 阿托伐他汀 超敏C反应蛋白 血清肌酐 肾小球滤过率 

分 类 号：R541[医药卫生—心血管疾病]