阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响

目的 探讨阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响。方法 选择2015年9月—2017年2月非缺血性心脏病慢性心衰患者102例，将所有患者随机分为对照组（n=51）和阿托伐他汀组（n=51）。对照组实施常规抗心衰药物治疗，阿托伐他汀组在常规抗心衰治疗基础上加用阿托伐他汀治疗，20 mg/d。两组疗程均为24周。观察并比较两组治疗前后三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、NYHA分级、左室射血分数（LVEF）、NT-proBNP、6 min步行距离（6MWT）、超氧化物歧化酶（SOD）、髓过氧化物酶（MPO）、丙二醛（MDA）等指标。结果 阿托伐他汀组治疗后TG、TC、LDL-C水平明显下降，与治疗前及对照组比较，差异均有统计学意义（P<0.05）。两组患者治疗后NT-proBNP水平均有明显下降，与治疗前比较，差异有统计学意义（P<0.05），但阿托伐他汀组下降幅度优于对照组，组间比较差异有统计学意义（P<0.05）。与同组治疗前及对照组比较，阿托伐他汀组治疗后SOD明显增高，MDA、MPO明显下降，差异均有统计学意义（P<0.05）；而对照组治疗前后无明显变化。结论 在常规抗心衰治疗的基础上加用阿托伐他汀，能有效降低CHF患者的NT-proBNP水平和抑制患者的氧化应激状态。

Influence of atorvastatin on levels of NT-proBNP, oxidative stress in patients with chronic heart failure

Objective To explore the influence of atorvastatin on N-terminal brain natriuretic peptide (NT-proBNP) and oxidative stress in patients with chronic heart failure (CHF). Methods 102 cases of chronic heart failure patients with non-ischaemic heart disease were chosen as chosen as the research objects. The patients were randomly divided into control group (n=51) and atorvastatin group (n=51). The patients were treated with the conventional drugs in control group, and combined with atorvastatin of 20 mg/d in atorvastatin group. All patients were treated for 12 weeks. Triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C), NYHA classification, left ventricular ejection fraction (LVEF), NT-proBNP, 6 min walking distance (6 MWT), SOD, MPO, MDA were observed and compared before and after treatment in two groups. Results Compared with before treatment and control group, TG, TC, LDL-C decreased obviously after treatment in atorvastatin group, the differences were statistically significant (P < 0.05). NT-proBNP levels decreased significantly after treatment in two groups, compared with that before treatment, the differences were statistically significant (P < 0.05), but the change in atorvastatin group was better than that in control group (P < 0.05). Compared with those before treatment and control group, SOD increased significantly, MDA, MPO decreased significantly after treatment in atorvastatin group, the differences were statistically significant (P < 0.05). The control group had no significant change before and after treatment. Conclusion The conventional anti-heart failure treatment added with atorvastatin could reduce effectively NT-proBNP level and inhibit oxidative stress in CHF patients.