阿托伐他汀对慢性心力衰竭患者血浆N端脑钠素前体水平及心功能的影响

目的探讨对慢性心力衰竭(CHF)患者血浆N端脑钠素前体(Nt-proBNP)水平和心功能的影响。方法将66例CHF患者随机分为阿托伐他汀组(36例)和对照组(30例),2组均给予常规治疗,阿托伐他汀组另加阿托伐他汀10mg,qn,疗程8周。测定治疗前、后左心室舒张末内径(LVDd)、左心室射血分数(LVEF)、血浆Nt-proBNP浓度的变化。结果阿托伐他汀治疗8周后,血浆Nt-proBNP浓度由(218.6±64.2)ng/L降至(149.4±50.1)ng/L(P<0.05);LVEF由(34.4±3.4)%升至(45.4±4.9)%(P<0.05),LVDd由(65.5±5.1)mm降至(45.4±4.9)mm与对照组比较均差异有统计学意义(P<0.05),且患者血浆Nt-proBNP降低值与LVEF增加存在负相关(r=-0.78,P<0.05),而与LVDd减少呈正相关(r=0.79,P<0.05)。结论阿托伐他汀能明显改善心功能,抑制血浆Nt-proBNP增高。他汀类药物治疗心力衰竭的有效性,为心力衰竭的治疗提供了新的思路。

Effects of Atorvastatin on Cardiac Function and Plasma Level of N - terminal Pro - brain Natriuretic Peptide in Patients with Chronic Heart Failure

Objective To investigate the change of cardiac function and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with chronic heart failure(CHF)after Atorvastatin treatment.Methods Sixty-six patients with CHF were randomly divided into two groups:Atorvastatin group(36 patients)and control group(30 patients).Patients in the Atorvastatin group were given Atorvastatin 10mg/d for 8 weeks besides conventional therapy.Plasma NT-proBNP and echocardiographic indices were evaluated before and after 8 weeks'therapy.Results Atorvastatin significantly decreased LV diastolic dimensions and increased LV ejection fraction(P<0.05)as well as attenuated NT-proBNP(P<0.05)in patients in Atorvastatin group,compared with that in control group.Meanwhile,the change of NT-proBNP level was positively correlated with LVDd(r=0.79)(P<0.05),and negatively correlated with LVEF(r=-0.78)(P<0.05).Conclusion Atorvastatin may improve cardiac function and suppress plasma NT-proBNP in patients with CHF.