阿托伐他汀钙联合环磷腺苷与托拉塞米治疗老年慢性心功能不全的疗效及对血清BNP、Gal-3、sICAM-1水平的影响  

Efficacy of atorvastatin calcium combined with cyclophosphoadenosine and torasemide in the treatment of chronic cardiac insufficiency in the elderly and the effect on serum BNP, Gal-3 and sICAM-1 levels

作　　者：高淑彦 赵瑞芳 李文静 刘倩楠 沈青青 GAO Shu-yan;ZHAO Rui-fang;LI Wen-jing(Department of Cardiology,Xingtai Central Hospital,Xingtai Hebei 054000,China;Department of Neurosurgery,Xingtai Central Hospital,Xingtai Hebei 054000,China)

机构地区：[1]邢台市中心医院心内科,河北邢台054000 [2]邢台市中心医院神经外科,河北邢台054000 [3]邢台市中心医院产科,河北邢台054000 [4]邢台市中心医院心脏康复科,河北邢台054000

出　　处：《临床和实验医学杂志》2025年第1期5-9,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省卫生健康委医学科学研究项目(编号:20191676)。

摘　　要：目的 观察阿托伐他汀钙联合环磷腺苷与托拉塞米治疗老年慢性心功能不全患者的效果及对血清脑钠肽(BNP)、半乳糖凝聚素3(Gal-3)、可溶性细胞间黏附因子1(sICAM-1)水平的影响。方法 前瞻性选取2023年1月至12月邢台市中心医院收治的135例老年慢性心功能不全患者为研究对象。按照随机数字表法将其分为常规组(n=67)和联合组(n=68)。常规组给予环磷腺苷与托拉塞米治疗,联合组给予阿托伐他汀钙联合环磷腺苷与托拉塞米治疗。统计两组疗效,比较两组心功能相关指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室短轴缩短率(FS)、舒张早期二尖瓣血流最大流速与心房收缩期二尖瓣血流最大流速的比值(E/A)]、血脂[总胆固醇、甘油三酯、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]及BNP、Gal-3、sICAM-1的差异,并观察两组不良反应发生情况。结果 联合组总有效率为89.71%,高于常规组(74.63%),差异有统计学意义(P<0.05)。治疗后8周,两组LVEF、FS、E/A均较治疗前升高,LVEDD、LVESD均较治疗前下降,且联合组的LVEF、FS、E/A分别为(60.42±4.75)%、(29.11±2.67)%、1.08±0.17,均高于常规组[(51.74±5.36)%、(26.93±3.14)%、0.94±0.14],LVEDD、LVESD分别为(50.11±4.32)、(37.84±4.75) mm,均低于常规组[(52.23±4.96)、(40.85±5.16) mm],差异均有统计学意义(P<0.05)。治疗后8周,两组总胆固醇、甘油三酯水平均较治疗前下降,HDL-C水平均较治疗前升高,且联合组的总胆固醇、甘油三酯水平分别为(3.78±0.64)、(1.22±0.21) mmol/L,均低于常规组[(3.78±0.64)、(1.22±0.21) mmol/L],HDL-C水平为(1.57±0.27) mmol/L,高于常规组[(1.38±0.25) mmol/L],差异均有统计学意义(P<0.05);两组治疗后8周与治疗前以及组间治疗后8周的LDL-C水平比较,差异均无统计学意义(P>0.05)。治疗后8周,两组BNP、Gal-3、sICAM-1水平均较治疗前下降,且联合组Objective To observe the therapeutic effect of atorvastatin calcium combined with cyclophosphoadenosine and torasemide on the therapeutic efficacy and the effect of serum brain natriuretic peptide(BNP),galactose cohesin 3(Gal-3)and soluble intercellular adhesion factor 1(sICAM-1)levels in elderly patients with chronic cardiac insufficiency.Methods One hundred and thirty-five elderly patients with chronic cardiac insufficiency admitted to Xingtai Central Hospital from January to December 2023 were prospectively selected for the study.They were divided into the conventional group(n=67)and the combined group(n=68)according to the random number table method.The conventional group was given cyclophosphoadenosine and torasemide treatment,and the combined group was given atorvastatin calcium combined with cyclophosphoadenosine and torasemide treatment.The efficacy of the two groups was statistically analyzed.The cardiac function-related indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVEDD),left ventricular end-systolic internal diameter(LVESD),left ventricular fractional shortening(FS),ratio of early diastolic mitral flow velocity and atrial systolic mitral flow velocity(E/A)],blood lipids[total cholesterol,triglycerides,low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C)]and BNP,Gal-3,sICAM-1 of the two groups were compared.The occurrence of adverse reactions in the two groups was observed.Results The total effective rate of the combined group was 89.71%,which was higher than that of the conventional group(74.63%),the difference was statistically significant(P<0.05).At 8 weeks after treatment,the LVEF,FS and E/A of the two groups were higher than those before treatment,and the LVEDD and LVESD were lower than those before treatment,the LVEF,FS and E/A of the combined group were(60.42±4.75)%,(29.11±2.67)%and 1.08±0.17,respectively,which were higher than those of the conventional group[(51.74±5.36)%,(26.93±3.14)%and 0.94±0.14],and the LVEDD and LVESD were

关 键 词：阿托伐他汀钙 环磷腺苷 托拉塞米 老年 慢性心功能不全 心功能 

分 类 号：R54[医药卫生—心血管疾病]