阿托伐他汀对高血压性心脏病心力衰竭患者预后的影响

目的：探讨他汀类药物在高血压性心脏病心力衰竭治疗中的影响。方法：将80例高血压性心脏病心力衰竭患者随机分为治疗组（n=40）和对照组（n=40）。所有患者均给予常规治疗-抗高血压、抗心衰（β-受体阻滞剂、ACEI、利尿剂及地高辛），治疗组再用阿托伐他汀10mg／d治疗8周。治疗前后分别测量血脂水平、血浆肿瘤坏死因子-α（TNF-α）和C-反应蛋白（CRP）、左室射血分数（LVEF）、血管内皮功能。结果：治疗8周后，两组患者治疗前后LVEF差异均有统计学意义（P〈0．01），但治疗组较对照组改善更显著（P〈0．05）。治疗组前后血清总胆固醇和低密度脂蛋白（P〈0．05），血浆肿瘤坏死因子-α（TNF-α）和C-反应蛋白（CRP）、血管内皮功能差异亦有统计学意义（P〈0．01），而对照组前后比较无改变。结论：阿托伐他汀可以显著改善高血压性心脏病心力衰竭患者的心功能和血管内皮功能，提示他汀类药物可用于治疗非缺血性心力衰竭。

Effect of Atorvastatin in the treatment of heart failure due to hypertensive heart disease

Objective To study the effects of Statins in the treatment of heart failure due to hypertensive heart disease.Method Eighty patients with heart failure due to hypertensive heart disease were randomly divided into the treatment group(n=40)and the control group(n=40).All the patients received conventional treatment:antihypertension and anti-heart failure(β-blocker,ACEI,diuretics and digoxin).The treatment group received Atorvastatin(10 mg/d)for 8 weeks in addition.Before and after treatment,blood lipin,plasma tumor necrosing factor-α(TNF-α)and C-reactive protein(CRP),left ventricular ejection fraction(LVEF),and vascular endotheliun function were measured.Results After 8 weeks of treatment,LVEF was improved significantly in both groups(P<0.01),but that in the treatment group was improved more significantly than that in the control group(P<0.05).Serum total chlolesterol(TC)and low density lipoprotein(LDL)had obvious change in the treatment group berore and after therapy(P<0.05),the plasma TNF-α,CRP and vascular endotheliun function were aslo had obvious changes in the treatment group berore and after therapy(P<0.01),but the control group had no changes berore and after therapy.Conclusion Atorvastatin can remarkablely improve cardiac function and vascular endotheliun function in patients with heart failure due to hypertensive heart disease,and it suggests that Statin may have therapeutic benefits in nonischemic heart failure.