卡维地洛联合阿托伐汀对冠心病心力衰竭患者血管内皮功能的影响

目的观察卡维地洛和阿托伐汀联合治疗对冠心病慢性心力衰竭患者血管内皮功能的和心功能影响。方法冠心病心力衰竭患者60例，均给予常规抗心力衰竭治疗，分为3组：常规组16例；卡维地洛组22例，加用卡维地洛；联合用药组22例，加用卡维地洛和阿托伐汀。治疗前后均测定左心室舒张末期内径和左心室收缩末期内径、左心室射血分数及肱动脉血流介导的扩张反应。结果治疗12周后，3组患者治疗后肱动脉血流介导的扩张反应均高于治疗前，而3组治疗后左心室舒张末期内径、左心室收缩末期内径和左心室射血分数均较治疗前有改善：血流介导的扩张反应联合用药组的肱动脉改善较卡维地洛组明显（P〈0．05），卡维地洛组优于常规组（P〈0．01）。结论冠心病心力衰竭患者存在内皮功能障碍，卡维地洛可改善其心功能和血管内皮功能，缩小心腔径。这些效应在联合阿托伐汀治疗时更为明显。

Effect of carvedilol and atrovastatin on vascular endothelium function in patients with coronary heart disease and chronic heart failure

Objectives To investigate the effects of carvedilol combined with atrovastatin on vascular endothelium and left ventrieular functions in patients with coronary heart disease and chronic heart failure （CHF）. Methods Sixty patients with coronary heart disease and CHF were divided into CHF grouP （n=16）, earvedilol group （n=22） and carvedilol and atrovastatin group （n=22）. All patients were treated with routine anti-CHF therapy for 12-weeks, while patients in carvedilol group and in carvedilol and atrovastatin group were additionally treated with carvedilol or with carvedilol and atrovastatin respectively. Left ventricular end-diastolic dimension （LVEDd） , left ventricular end-systolic dimension （LVEDs） , left ventricular ejection fraction （LVEF） and brachial artery flow-mediated vasodilation （FMD） were detected before and after 12-week treatment. Results FMDs were higher after treatment for 12 weeks than those before treatment in all patients, besides more significance was seen in carvedilol and atrovastatin group （P〈0.05） ; More improvement in LVEDd, LVEDs and LVEF after treatment were found in earvedilol group （P〈0.05） and in carvedilol and atrovastatin group （P〈 0.01 ）. Conclusions Carvedilol improves the endothelium and heart functions and reduces cardiac chamber dimension in patients with coronary heart disease and CHF. The effects are more obvious with additional atrovastatin.