不同剂量瑞舒伐他汀对Ⅲ度房室传导阻滞起搏器术后患者NT-proBNP及心脏重构的影响

目的 探讨不同剂量瑞舒伐他汀对Ⅲ度房室传导阻滞双腔起搏器治疗患者NT-proBNP 及心脏重构的影响.方法 选取2011 年12 月至2012 年8 月于我院心血管内科因Ⅲ度房室传导阻滞(AVB)住院并行双腔起搏器(DDD)治疗的患者60 例,随机分为对照组、可定5 mg 组及可定10 mg 组各20 例.分别测定术前、术后12 个月三组患者NT-proBNP 水平、左房内径(LA)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)及左心室射血分数(LVEF).结果 三组患者治疗前NT-proBNP、LA、LVEDD、LVESD、LVEF 差异无统计学意义(P＞0.05).治疗后起搏器组及可定10 mg 组患者血浆NT-proBNP 水平较治疗前下降(P＝0.045,P＜0.01),可定10 mg 组较单纯起搏器组下降更明显,差异有统计学意义(P＝0.013).治疗后三组患者LVEDD 均较术前减小,且随可定用量增加减小更明显.治疗后可定5 mg 组LVESD 较术前减小(P＜0.01),LVEF 明显增高(P＝0.032);治疗后可定10 mg 组LA、LVESD 较术前减小(P 均＜0.01),LVEF 明显增高(P＝0.017).治疗后可定5 mg 组及可定10 mg 组LA 较起搏器组明显减小(P＝0.048,P＝0.043),LVESD 减小,差异有统计学意义(P＝0.037,P＝0.031).治疗后三组患者射血分数增高差异无统计学意义.结论 瑞舒伐他汀在一定程度上可逆转Ⅲ度房室传导阻滞双腔起搏器置入患者心脏重构,改善心功能.

The effects of different doses of rosuvastatin on NT-proBNP level and cardiac remodeling in patients with HI o atrioventricular block and dual chamber pacemaker

Objective To evaluate the effect of rosuvastatin on NT-proBNP and cardiac remodeling fol- lowing dual chamber pacemaker implantation in the patients with Ⅲ° atfioventficular block. Methods 60 Ⅲ° a- trioventricular block patients who received the dual chamber pacemaker implantation were selected in this study. They were divided into the control group （n=20）, rosuvastatin 5 mg group （n=20） and 10 mg group （n=20） ran- domly. NT-proBNP, LA diameter, LVEDD, LVESD and LVEF were measured at baseline and 12 months. Results Baseline data were similar between the three groups （P〉0.05）. Plasma NT-proBNP level decreased after 12 months of treatment in both pacemaker group and 10 mg group （P〈0.01）. NT-proBNP and LA were significantly reduced in 10rag group but not in control group （P=0.05, P=0.048）. There was no significant difference in LVEF among the three groups after operation. Conclusion Intensive statin therapy was effective for preventing ventficu- lar remodeling and improving cardiac function after dual-chamber-pacemaker implantation in SSS patients.