辅助阿托伐他汀钙治疗对扩张型心肌病患者心功能及血清Cys-C的影响  

Effect of atorvastatin on cardiac function and serum Cys-C in patients with dilated cardiomyopathy

作　　者：陈慧[1] 李敏[1] 刘蕾[1] 党夏薇 朱丹军[1] 田刚[1] CHEN Hui;LI Min;LIU Lei;DANG Xia-wei;ZHU Dan-jun;TIAN Gang(Department of Cardiology,the First Affiliated Hospital of Xi＇ an Jiao Tong University,Xi＇ an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061

出　　处：《心脏杂志》2018年第5期558-561,574,共5页Chinese Heart Journal

基　　金：国家"973"科技支撑计划项目资助(2011BAI11B23)

摘　　要：目的观察辅助阿托伐他汀钙治疗对扩张型心肌病(DCM)患者心功能及血清胱抑素(Cys)-C影响。方法选取住院的48例心功能II^IV级DCM患者,测定患者心脏超声参数、血浆氨基末端脑钠尿肽前体(NT-proBNP)及血清Cys-C等血清生化指标,将患者随机分为常规试药组(对照组,27例)及辅助阿托伐他汀钙试药组(试药组,21例),后者在常规治疗基础上联用阿托伐他汀钙20 mg/d,治疗12个月后测定并比较两组心超参数及Cys-C等血清生化指标。结果 (1)试药组治疗12个月后心功能改善程度优于对照组(P <0. 01),左室舒张末内径(LVEDD)、血清NT-proBNP及Cys-C水平低于对照组(P <0. 05,P <0. 01);(2) DCM患者血清Cys-C水平与左室射血分数(LVEF)、NT-proBNP、血肌酐(SCr)及肾小球滤过率(GFR)呈强相关性(P <0. 01)。结论长期常规剂量辅助阿托伐他汀钙治疗可改善DCM患者心功能,逆转心肌重构,该作用可能与其下调患者血清Cys-C水平相关。AIM To observe the effect of atorvastatin on cardiac function and serum cystatin （Cys） -C in patients with dilated cardiomyopathy （DCM）. METHODS Forty-eight patients with DCM （NYHA cardiac function grade：II-IV） were chosen to evaluate eehoeardiography parameters, plasma N-terminal pro-B-type natriuretic peptide （NT-proBNP） , serum Cys-C, and other serum biochemical indexes from October 2011 to January 2015. Patients were randomly divided into a routine treatment group （control group, n = 27） and an auxiliary atorvastatin treatment group （treatment group, n = 21 ）, and the treatment group received atorvastatin 20 mg/d plus routine therapy, the other received routine therapy only. 12 months later, eehoeardiography parameters, Cys-C, and other serum bioehernieal indexes were measured and eompared. RESULTS After 12 months of treatment, the heart function of the treatment group were significantly improved when eompared to the eontrol group （ P 〈 0. 01 ）. Left ventrieular end diastolic diameter （ LVEDD）, serum NT-proBNP, and Cys-C levels were lower than the control group （P 〈 0. 05, P 〈0. 01）; The serum Cys-C levels were strongly correlated with left ventrieular ejection fraction （LVEF）,serum creatinine （SCr）, NT-proBNP, and glomerular filtration rate （GFR） in patients with DCM （P 〈0. 01 ）. CONCLUSION Long term treatment with atorvastatin calcium in routine doses improved heartfunction and reversed myocardial remodeling in patients with DCM. This beneficial effect may be relatedto reduction of serum levels of Cys-C.

关 键 词：心肌病 扩张型 阿托伐他汀钙 心功能 血清胱抑素C 

分 类 号：R542.2[医药卫生—心血管疾病]