阿托伐他汀对慢性心力衰竭患者心肌纤维化的影响

目的探讨阿托伐他汀在防治慢性心力衰竭(CHF)患者心肌纤维化、逆转心室重塑中的作用。方法选择CHF患者69例,随机分为治疗组(35例)和对照组(34例)。2组均给予剂量相似的ACEI、利尿剂、地高辛和β-受体阻滞剂。治疗组另加用阿托伐他汀20mg口服,每日1次,均服用12周。治疗前及用药后12周分别检测III型前胶原氨基末端肽(PIIINP)及心功能指标。结果治疗12周后治疗组PIIINP、左室射血分数(LVEF)、左心室质量指数(LVMI)、左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)均较治疗前有明显改善,差异亦有统计学意义(P均<0.01);且均较对照组有明显改善,差异亦有统计学意义(P均<0.05)。对照组PIIINP、LVEDVI、LVESVI较治疗前有所改善(P均<0.05),LVEF、LVMI改善不明显(P均>0.05)。结论短期小剂量阿托伐他汀治疗可以更好地改善CHF心肌纤维化,改善CHF患者的左心室重塑。

Effects of atorvastatin on myocardium fibrosis in chronic heart failure

Objective To investigate the effects of atorvastatin on myocardium fibrosis and reverse ventricular remodeling in chronic heart failure （CHF） .Methods Sixty-nine cases with CHF were randomly divided into treatment group （35 cases） and control group （34 cases）. Both groups were underwent treatment with similar dosage of ACEI, diuresis drug, digoxin, 3-blocker. Besides, the atorvastatin was used in treatment group （20 mg, po, qd, lasted 12w）. The PIIINP and cardiac function parameters were measured regularly before and 12 weeks after medicine intervention respectively. Results After 12 weeks, the PIIINP and cardiac function indexes improved in treatment group obviously （ P 〈 0.01 ）, included LVEF, LVMI, LVEDVI, LVESVI. In control group, the PIIINP, IXEDV1, LVESVI improved （ P 〈 0.05）, while it had no statistical significant change in the level of LVEF and LVMI （ P 〉 O. 05）. Conclusion It suggested that short-term low dose atorvastatin applied in CHF may improve myocardium fibrosis, and reversed the left ventricular remodeling.