不同剂量氟伐他汀治疗老年冠心病伴心力衰竭的临床疗效及其对心功能、血清炎性因子水平、血浆N-末端脑钠肽前体水平的影响研究  

Clinical Effect of Different Doses of Fluvastatin in Treating Elderly Coronary Artery Disease Patients Complicated With Heart Failure and the Impact on Cardiac Function,Serum Levels of Inflammatory Cytokines and Plasma NT-proBNP Level

作　　者：师志芳[1] 李立鹏[2] 代婧[1] 韩建妙[1] 

机构地区：[1]河北省石家庄市第三医院干部病房,050000 [2]河北医科大学第二医院生殖中心

出　　处：《实用心脑肺血管病杂志》2016年第1期20-24,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探究不同剂量氟伐他汀治疗老年冠心病伴心力衰竭的临床疗效及其对心功能、血清炎性因子水平、血浆N-末端脑钠肽前体(NT-pro BNP)水平的影响。方法选取2012年在石家庄市第三医院住院治疗的老年冠心病伴心力衰竭患者90例(年龄>65岁),随机分为对照组、治疗1组、治疗2组,每组30例。患者入院后均根据病情给予基础治疗,治疗1组患者在此基础上给予常规剂量氟伐他汀(40 mg/d)治疗,治疗2组患者在此基础上给予大剂量氟伐他汀(80 mg/d)治疗。3组患者均治疗1年。比较3组患者临床疗效,治疗前后心功能指标〔左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)〕、血清炎性因子〔肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)〕、血浆NT-pro BNP及同型半胱氨酸(Hcy)水平、血脂指标〔低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)〕、肝功能指标〔丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)〕。结果治疗1组、治疗2组患者临床疗效优于对照组(P<0.05);治疗1组与治疗2组患者临床疗效比较,差异无统计学意义(P>0.05)。3组患者治疗前LVEDD、LVESD、LVFS、LVEF比较,差异无统计学意义(P>0.05);治疗1组及治疗2组患者治疗后LVEDD、LVESD低于对照组,LVFS、LVEF高于对照组(P<0.05);治疗2组患者治疗后LVEDD、LVESD低于治疗1组(P<0.05),而治疗1组与治疗2组患者治疗后LVFS、LVEF比较,差异无统计学意义(P>0.05)。3组患者治疗前血清hs-CRP、TNF-α水平及血浆NT-pro BNP、Hcy水平比较,差异无统计学意义(P>0.05);治疗1组患者治疗后血清hs-CRP、TNF-α水平及血浆NT-pro BNP、Hcy水平均低于对照组(P<0.05);治疗2组患者治疗后血清hs-CRP、TNF-α水平及血浆NT-pro BNP、Hcy水平均低于治疗1组及对照组(P<0.05)。3组患者治疗前LDL-C、TC、ALT、AST比较,差异无统计学意义(P>0.05);治疗1组及治�Objective To observe the clinical effect of different doses of fluvastatin in treating elderly coronary artery disease patients complicated with heart failure, to investigate the impact on cardiac function, serum levels of inflammatory cytokines and plasma NT-pro BNP level. Methods A total of 90 elderly coronary artery disease inpatients complicated with heart failure（ over 65 years old） were selected in the Third Hospital of Shijiazhuang in 2012,and they were randomly divided into A group,B group and C group,each of 30 cases. Patients of the three groups received basal treatment according to severity of illness,patients of B group received extra standard dose of fluvastatin（ 40 mg / d）,while patients of C group received large dose of fluvastatin（ 80 mg / d）; all of the three groups treated for 1 year. Clinical effect,cardiac function index（ including LVEDD,LVESD,LVFS and LVEF）, serum levels of inflammatory cytokines（ including TNF-α and hs-CRP）, plasma levels of NT-pro BNP and Hcy,blood lipids index（ including LDL-C and TC）,liver function indicators（ including ALT and AST） were compared among the three groups. Results The clinical effect of B group and C group was statistically significantly better than that of A group,respectively（ P〈0. 05）,while no statistically significant differences of clinical effect was found between B group and C group（ P〈0. 05）. No statistically significant differences of LVEDD,LVESD,LVFS or LVEF was found among the three groups before treatment（ P〈0. 05）; after treatment,LVEDD and LVESD of B group and C group were statistically significantly lower than those of A group,LVFS and LVEF of B group and C group were statistically significantly higher than those of A group,LVEDD and LVESD of C group were statistically significantly lower than those of B group（ P〈0. 05）,while no statistically significant difference of LVFS or LVEF was found between B group and C group（ P〈0. 05）. No statistically significant differences of serum level o

关 键 词：冠心病 心力衰竭 氟伐他汀 心室功能 肿瘤坏死因子类 C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]