阿托伐他汀对充血性心力衰竭的治疗作用及对TNF-α、IL-10水平的影响

目的:研究不同剂量阿托伐他汀对充血性心力衰竭(CHF)的治疗作用以及对肿瘤坏死因子-α(TNF-α)和白细胞介素-10(IL-10)水平的影响。方法:60例CHF患者分为3组,对照组(n=18)常规予强心、利尿和血管扩张剂治疗,小剂量阿托伐他汀组(n=20)在前者基础上加用阿托伐他汀片(10mg/d),大剂量阿托伐他汀组(n=22)则在基础治疗上加用阿托伐他汀片(40mg/d),各治疗8周。观察治疗前后心功能NYHA分级、心脏超声指标、血清TNF-α和IL-10水平的变化。结果:经8周治疗后,3组的临床症状及心功能均有所改善,阿托伐他汀组的心脏超声指标改善与对照组相比差异有显著性(P<0.01),大剂量阿托伐他汀组的疗效更为显著;无论小剂量还是大剂量阿托伐他汀组的血清TNF-α水平均较对照组明显降低,而IL-10水平则明显升高(P<0.01)。结论:在常规治疗的基础上加用阿托伐他汀可以更好地改善CHF患者的心功能,大剂量者疗效更为显著。阿托伐他汀能明显降低血清TNF-α水平,升高IL-10水平,这可能是阿托伐他汀治疗CHF的机制之一。

Clinical study of atorvastatin in patients with congestive heart failure and effect of atorvastatin on serum tumor necrosis factor-alpha and interleukin-10

【Abstract】 Objective: To investigate the effect of atorvastatin in patients with congestive heart failure(CHF)and to observe the effect of atorvastatin on the serum level of tumor necrosis factor-alpha (TNF-α) and interleukin-10(IL-10)in them．Methods :Sixty patients with CHF were randomly divided into routine therapy group(control group，n=18),which were administered cardiotonic,diuretic and vascellum expander;low dose atorvastatin group (n=20)and high dose atorvastatin group (n=22),which were supplemented by atorvastatin 10mg/day and 40mg/day separately, besides the routine therapy for 8 weeks.Before and after 8 weeks of the therapy，the changes of NYHA class，echocardiographic parameters, serum level of TNF-α and IL-10 were measured.Results : Eight weeks post-treatment clinical symptom and heart function of patients in three groups were all improved.As compared with control group , amelioration of echocardiographic parameters was better in atorvastatin group and the effect in high dose atorvastatin group were more remarkablely (p<0.01) . serum level of TNF-α were significantly lower than those before treatment compared with control group, while serum level of IL-10 notablely heightened in not only low dose but also high dose atorvastatin group (p<0.01)．Conclusion: Supplementing atorvastatin can more improve heart function of the patients with CHF than that only accepted routine therapy.atorvastatin can effectively depress the level of serum TNF-α and heighten the level of serum IL-10 in patients with CHF,which was maybe a mechanism of atorvastatin anti-heart failure.