文章摘要
张淑平,李永强,刘宏颖,等.小剂量阿托伐他汀钙辅助治疗对冠心病合并心力衰竭患者血清脑钠肽水平及心功能的影响[J].安徽医药,2018,22(10):2011-2014.
小剂量阿托伐他汀钙辅助治疗对冠心病合并心力衰竭患者血清脑钠肽水平及心功能的影响
Effects of low-dose atorvastatin calcium supplementation on plasma BNP levels and cardiac function in patients with coronary heart disease and heart failure
投稿时间:2017-05-11  
DOI:
中文关键词: 冠心病  心力衰竭  利钠肽,脑  每搏输出量  阿托伐他汀钙
英文关键词: Coronary disease  Heart failure  Natriuretic peptide,brain  Stroke volume  Atorvastatin calcium
基金项目:
作者单位
张淑平 遵化市人民医院心内科,河北 唐山 064200 
李永强 遵化市人民医院麻醉科,河北 唐山 064200 
刘宏颖 遵化市人民医院心内科,河北 唐山 064200 
王全力 遵化市人民医院心内科,河北 唐山 064200 
那雪峰 遵化市人民医院心内科,河北 唐山 064200 
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中文摘要:
      目的 研究小剂量阿托伐他汀钙对冠心病合并心力衰竭患者血清脑钠肽(BNP)水平及心功能的影响。 方法 选取遵化市人民医院2015年2月至2016年2月收治的108例冠心病合并心力衰竭患者,采用随机数字表法分为对照组和观察组,每组54例。对照组给予常规治疗,观察组在此基础上加用阿托伐他汀钙,剂量为20 mg·d-1,两组均连续治疗4周。采用试剂盒测定患者血脂、血清超敏C-反应蛋白(hs-CRP)及BNP水平,采用心脏彩超测定患者左心室射血分数(LVEF),同时观察患者治疗前后6 min步行距离,记录治疗期间不良反应与心脏不良事件(MACE)发生率。 结果 治疗后,观察组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,高密度脂蛋白胆固醇(HDL-C)水平高于对照组,组间差异有统计学意义(t值分别为7.34、2.35、4.45、9.67,均P<0.01);观察组血清hs-CRP、BNP水平低于对照组,LVEF高于对照组,6 min步行距离远于对照组,组间差异有统计学意义(t值分别为6.86、10.51、7.90、6.82,均P<0.01);同时,观察组MACE发生率5.55%低于对照组18.51%,组间差异有统计学意义(χ2=4.285,P<0.01)。 结论 小剂量阿托伐他汀钙能够降低血脂水平,减轻机体炎性反应,改善心功能,辅助治疗冠心病合并心力衰竭利于提高疗效,降低MACE发生率,值得临床推广使用。
英文摘要:
      Objective To study the effects of small dose of atorvastatin calcium on plasma brain natriuretic peptide (BNP) and cardiac function in patients with coronary heart disease and heart failure. Methods One hundred and eight subjects with coronary heart disease and heart failure in Zunhua People's Hospital from February 2015 to February 2016 were selected.The patients were assigned into control group and observation group randomly,with 54 cases in each group.The patients in the control group were given conventional anti-heart failure treatment,while those in the observation group were given additional treatment of atorvastatin calcium,20 mg·d-1,and all patients were treated for 4 weeks.The lipid indicators,the levels of plasma high-sensitivity C-reactive protein (Hs-CRP) and BNP were detected by reagent box.The left ventricular ejection fraction (LVEF) was detected by cardiac color Doppler ultrasonography,and 6 min walking distance before and after treatment was observed too.At the same time,the adverse reactions and the major adverse events (MACE) incidence during treatment were both recorded. Results After 4 weeks of treatment,the levels of serum TC,TG and LDL-C in the observation group were significantly lower than those in the control group,and the differences between the groups were statistically significant (t=7.34,2.35,4.45,respectively,P<0.01),while the level of HDL-C in the observation group was significantly higher than that in the control group (t=9.67,P<0.01).The levels of hs-CRP and BNP in the observation group were significantly lower than that in the control group (t=6.86,0.51,respectively,P<0.01).LVEF in the observation group was significantly higher than that in the control group.The 6 min walking distance in the observation group was for longer than the control group,and the difference between the groups was statistically significant (t=6.86,0.51,7.90,6.82,respectively,all P<0.01).The incidence rate of MACE in the observation group was significantly lower than that in the control group (5.55% vs. 18.51%,χ2=4.285,P<0.01). Conclusions Low-dose atorvastatin calcium can improve the patient's cardiac function,reduce the plasma lipid levels and inflammatory response,and assist in the treatment of coronary heart disease combined with heart failure to improve the curative effect and reduce the incidence of MACE,which is worthy of clinical use and promotion.
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