不同剂量辛伐他汀与阿托伐他汀分别联合曲美他嗪对CHF患者血脂及心功能的影响  

Effects of different doses of simvastatin and atorvastatin combined with trimetazidine on blood lipids and cardiac function in patients with chronic heart failure

作　　者：冯莹 韩真[1] Feng Ying;Han Zhen(Department of Internal Medicine,Jinan Second People's Hospital,Jinan 250000,Shandong Province,China)

机构地区：[1]济南市第二人民医院内科,济南250000

出　　处：《中国基层医药》2023年第8期1144-1149,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探索不同剂量辛伐他汀与阿托伐他汀分别联合曲美他嗪对慢性心力衰竭(CHF)患者血脂及心功能的影响。方法选取济南市第二人民医院2019年9月至2021年8月收治的CHF患者100例为观察对象,根据治疗方法不同分为A(33例)、B(33例)、C(34例)三组,A组采用常规剂量辛伐他汀联合曲美他嗪治疗,B组采用大剂量辛伐他汀联合曲美他嗪治疗,C组采用阿托伐他汀联合曲美他嗪治疗,均治疗6个月,比较三组治疗后心功能、血脂、炎性因子以及优良率,统计用药期间不良反应。结果B组和C组血脂、心功能、血清炎性因子以及各时间段优良率比较,差异均无统计学意义(均P>0.05)。治疗后6个月,B组和C组高密度脂蛋白胆固醇(HDL-C)[(1.99±0.25)mmol/L、(2.01±0.16)mmol/L]、左室射血分数(LVEF)[(51.29±4.15)%、(51.37±4.44)%]均显著高于A组[(1.52±0.16)mmol/L、(42.28±4.86)%](t=9.10、6.24;8.10、11.38,均P<0.05),半胱氨酸蛋白酶1(Caspase-1)[(42.33±3.19)ng/L、(41.87±3.55)ng/L]、白细胞介素18(IL-18)[(54.55±4.39)ng/L、(53.98±4.45)ng/L]、左心室收缩末期内径(LVESD)[(35.13±2.13)mm、(35.68±2.46)mm]、左心室舒张末期内径(LVEDD)[(44.39±3.65)mm、(44.42±3.32)mm]、低密度脂蛋白胆固醇(LDL-C)[(2.69±0.39)mmol/L、(2.57±0.13)mmol/L]、总胆固醇(TC)[(3.79±0.13)mmol/L、(3.56±0.69)mmol/L]、三酰甘油(TG)[(1.12±0.05)mmol/L、(1.10±0.07)mmol/L]水平均显著低于A组[(68.41±10.23)ng/L、(88.37±6.65)ng/L、(42.63±3.13)mm、(51.68±5.42)mm、(3.13±0.11)mmol/L、(4.21±0.11)mmol/L、(1.51±0.11)mmol/L](t=-13.98、-24.38、-14.27、-24.95、-6.41、-5.64、-8.00、-10.12、-14.17、-18.54、-12.53、-19.01、-5.35、-18.26,均P<0.05),6 min步行距离[(352.19±25.4)m、(351.74±24.29)m]长于A组[(319.71±21.11)m](t=6.63、5.75,均P<0.05),治疗后3个月及6个月的优良率均显著高于A组(χ^(2)=4.00、4.16,均P<0.05),但B组不良反应发生率[18.18%(6/33)]均高于A组[3.03%(1/33)]和C组[2.94%(1/34)](�Objective To investigate the effects of different doses of simvastatin and atorvastatin combined with trimetazidine on blood lipids and cardiac function in patients with chronic heart failure.Methods A total of 100 patients with chronic heart failure who received treatment in Jinan Second People's Hospital from September 2019 to August 2021 were included in this study.These patients were divided into three groups according to different treatment methods:group A(n=33),group B(n=33),and group C(n=34).Group A was treated with a conventional dose of simvastatin combined with trimetazidine.Group B was treated with a high dose of simvastatin combined with trimetazidine.Group C was treated with atorvastatin combined with trimetazidine.All patients were treated for 6 months.Cardiac function,blood lipids,inflammatory factors,and excellent and good rates of therapeutic effects post-treatment were compared between the three groups.The adverse events during the treatment were recorded.Results There were no significant differences in blood lipids,cardiac function,inflammatory factors,and excellent and good rates of therapeutic effects between the two groups(all P>0.05).After 6 months of treatment,high-density lipoprotein cholesterol[(1.99±0.25)mmol/L,(2.01±0.16)mmol/L]and left ventricular ejection fraction[(51.29±4.15)%,(51.37±4.44)%]in groups B and C were significantly higher than those in group A[(1.52±0.16)mmol/L,(42.28±4.86)%,t=9.10,6.24;8.10,11.38,all P<0.05].Caspase-1[(42.33±3.19)ng/L,(41.87±3.55)ng/L],interleukin-18[(54.55±4.39)ng/L,(53.98±4.45)ng/L],left ventricular end-systolic diameter[(35.13±2.13)mm,(35.68±2.46)mm],left ventricular end-diastolic diameter[(44.39±3.65)mm,(44.42±3.32)mm],low-density lipoprotein cholesterol[(2.69±0.39)mmol/L,(2.57±0.13)mmol/L],total cholesterol[(3.79±0.13)mmol/L,(3.56±0.69)mmol/L],triacylglycerol[(1.12±0.05)mmol/L,(1.10±0.07)mmol/L]levels in groups B and C were significantly lower than those in group A[(68.41±10.23)ng/L,(88.37±6.65)ng/L,(42.63±3.13)mm,(51.68±5.4

关 键 词：心力衰竭 慢性病 曲美他嗪 羟甲基戊二酰基COA还原酶抑制剂 阿托伐他汀钙 剂量效应关系 药物 炎症介导素类 心脏功能 药物相关性副作用和不良反应 

分 类 号：R541.6[医药卫生—心血管疾病]