阿托伐他汀对PCI冠心病CHF患者NT-proBNP、hs-CRP和左室重构的影响

目的 观察阿托伐他汀对经皮冠状动脉介入术(PCI)后慢性心力衰竭(CHF)患者氨基末端脑钠肽前体( NT-proBNP)、超敏C反应蛋白(bs-CRP)和左室重构的影响及相关性.方法 122例PCI术后CHF患者(NYHA分级Ⅱ/Ⅲ)随机分为阿托伐他汀20 mg组(阿托代他汀20 mg/d治疗,n=62)和阿托伐他汀他汀10mg组(阿托伐他汀10 mg/d治疗,n=60),比较两组治疗前一般资料、两组治疗前和治疗12个月后血浆NT-proBNP和hs-CRP水平以及左室重构相关指标的变化,并分析其相关性.结果 两组治疗后血浆NT-proBNP和hs-CRP水平均较治疗前显著降低(P＜0.05),治疗后阿托伐他汀20 mg组血浆NT-proBNP和hs-CRP水平显著低于阿托伐他汀10mg组(P＜0.05).阿托伐他汀治疗后,两组左室舒张末期内径( LVEDD)较治疗前均显著降低(P＜0.05),两组左室射血分数(LVEF)较治疗前均显著升高(P＜0.05),阿托伐他汀20 mg组左室舒张末期内径(LVEDD)显著小于阿托伐他汀10 mg组(P＜0.05)；阿托伐他汀20 mg组LVEF显著大于阿托伐他汀10 mg组(P＜0.05).两组治疗前后血浆NT-proBNP和hs-CRP的下降水平均与LVEDD减少呈正相关,与LVEF增加呈负相关；NT-proBNP、hs-CRP下降水平两者呈正相关(均P＜0.05).结论 阿托伐他汀对PCI冠心病CHF患者心功能改善有益,且与药物剂量有关.

Changes of plasma NT-ProBNP and hs-CRP levels and relationship with left ventricular remodeling in patients treated by Atorvastatin with CHF after PCI therapy

【Objective】 To investigate the effects of atorvastatin on N-terminal pro-brain natriuretic peptide(NT-ProBNP) and high sensitive C reactive protein(hs-CRP) as well as left ventricular remodeling in patients with chronic heart failure(CHF) after percutaneous coronary intervention(PCI).【Methods】 A total of 122 CHF(Ⅱ/Ⅲ of NYHA Classification) patients who received PCI were randomized to atorvastatin 20 ㎎/day(n =62) and atorvastatin 10 mg/day(n =60).Before and after 12 months treatment,cardiac function was evaluated by echocardiography,and the plasma levels of NT-proBNP and hs-CRP were examined by flow cytometric analysis and enzyme-linked immuno sorbent assay(ELISA).【Results】 Baseline data were similar between the two groups.NT-proBNP,hs-CRP and LVEDD were decreased while LVEF was increased in both therapy group after 12 months compared with those pre-therapy(P <0.05,respectively).The levels of NT-proBNP,hs-CRP and LVEDD to those in the atorvastatin 10 mg/day group were significantly reduced in the atorvastatin 20 mg/day group(380.4±56.7vs.320.3±98.2,1.7±0.2 vs.1.2±0.3,39±10 vs.37±11,respectively;P <0.05).But LVEF was conspicuously higher in the atorvastatin 20 ㎎/day group than those in the atorvastatin 10 ㎎/day group(44±3 vs.41±2,respectively;P <0.05).The expression of NT-proBNP and hs-CRP was positively correlated with each other(r =0.74,P <0.05) and with the LVEDD(r =0.66 and r =0.71,respectively;P <0.05).But they were negatively correlated with the LVEF(r =-0.78 and r =-0.63,respectively;P <0.05).【Conclusion】 Atorvastatin had beneficial effects on cardiac function for CHD patients who treated with PCI.