曲美他嗪联合他汀治疗对慢性心衰患者血清CRP及MMP-9的影响

目的：研究曲美他嗪联合阿托伐他汀对慢性心力衰竭（CHF）患者的疗效及其机制。方法：109例CHF患者被随机分为常规治疗组（56例）和曲美他嗪联合阿托伐他汀干预组（联合干预组，53例），分别检测两组治疗前、治疗2周及6月后的超敏c反应蛋白（hsCRP）、基质金属蛋白酶（MMP）-9及左室射血分数（LVEF）、左室舒张末内径（LVEDd）的变化。结果：与常规治疗组相比，联合干预组治疗后2周及6月hsCRP6个月后：（4．47±2．37）mg／L比（3．11±2．04）mg／L]、MMP-9F6个月后：（558．69±210．14）ng／L比（442．77±183．25）ng／L]水平显著降低（P均〈0．05），LVEF值显著提高6个月后：（51．4±4．4）％比（57．3±5．1）％，P〈0．05]，LVEDd无显著差异（P〉0．05）；但联合干预组LVEDd较治疗前明显降低（54．5±6．1）mm比（59．7±6．3）mm，P〈0．05）。结论：曲美他嗪联合阿托伐他汀治疗可降低慢性心力衰竭患者超敏c反应蛋白及基质金属蛋白酶-9水平，改善心室重构及心功能。

Influence of trimetazidine combined statin therapy on serum CRP and MMP-9 in patients with chronic heart failure

Objective： To study therapeutic effects of trimetazidine （TMZ） combined atorvastatin in patients with chronic heart failure （CHF） and its mechanism. Methods： A total of 109 CHF patients were randomly divided into routine treatment group （n = 56） and TMZ ± atorvastatin intervention group （combined intervention group, n = 53）. Changes of levels of high sensitive C reactive protein （hsCRP）, matrix metalloproteinase （MMP） -9, left ventricular ejection fraction （LVEF） and left ventricular end- diastolic dimension （LVEDd） were measured and compared between two groups before treatment, two weeks and six months after treatment. Results.- Compared with routine treatment group, there were significant decrease in levels of hsCRP after six months： （4.47± 2.37） mg/L vs. （3.11 ± 2.04） mg/L] and MMP- 9 after six months： （558.69 ± 210.14） ng/L vs. （442.77 ± 183.25） ng/L, P 〈0.05 both], and significant increase in LVEF after six months： （51.4 ± 4. 4） % vs. （57.3 ± 5.1） %, P〈0.05] in combined intervention group on two weeks and six months after treatment; the LVEDd was not significant different between two groups after treatment （P〉0.05）, but LVEDd of combined intervention group was significantly lower than that of before treatment （54. 5 ± 6.1） mm vs. （59.7 ± 6.3） mm, P〈0.05]. Conclusion.. Trimetazidine combined atorvastatin therapy can decrease levels of high sensitive C reactive protein, matrix metalloproteinase- 9 and improve ventricular remodeling and cardiac function in patients with chronic heart failure.