阿托伐他汀对射血分数保留的心衰临床治疗研究

目的探讨阿托伐他汀治疗射血分数保留的心衰（HFPEF）患者的有效性及安全性。方法将70例HFPEF患者,随机分为阿托伐他汀组35例（阿托伐他汀20mg/d＋基础治疗）、对照组35例（仅予基础治疗）,分别于治疗前、治疗后1个月、3个月及12个月时测量E/E’比值、E/A比值、E峰减速时间（DT）、左室质量指数（LVMI）、左房容积指数（LA VI）,同时检测血浆N末端脑利纳肽前体（NT-proBNP）、高敏C反应蛋白（hs-CRP）、测定6 min步行距离（6MWT）。结果治疗3月时,2组超声指标较治疗前有明显改善（P〈0 05）,但此时2组间比较差异无统计学意义（P〉0.05）。治疗12月时,阿托伐他汀组与对照组比较6MWT有显著提高（463±57vs411±59,P〈0.05）,体现左室舒张功能的超声指标与对照组比较如E/E’改善显著（8.0±2.8vs10.8±3.0,P〈0 05）、验血指标方面hs-CRP与对照组比较在治疗3月时即有差异,治疗12个月时改善显著（3.02±0.43vs4.73±0.68,P〈0 05）,同时12月时阿托伐他汀组临床复合终点事件较对照组发生率低。结论阿托伐他汀能改善HFPEF患者的左室舒张功能,减轻临床症状,可能对预后有改善作用。

Effects of atorvastatin on heart failure with preserved ejection fraction

0bjective To explore the effects of statins on heart failure with preserved ejection fraction.Methods 70 patients were randomly divided into 2 groups： atorvastatin group（35 caes and given atorvastatin 20mg/d＋ conventional treatment）,and control group（35 cases only given conventional treatment）.E/E ’ratio,E/A ratio,E peak deceleration time（DT）,left ventricular mass index（LVMI）,left atrioventricular volume index（LAVI）,and check NT-proBNP,hs-CRP were measured before treatment,a month,three months and 12 months after treatment Results Significantl improvement in echocardiography index was noticed（P 〈 0 05）,but at that moment the 2 groups showed no statistically significant difference（P 〉 0.05）.Treated after 12months 6 MWT of atorvastatin group is significantly higher than control group（463 ± 57 vs 411 ± 59 P 〈 0 05）,E/E ’ ratio also showed a significantly improvement than control group（8.0 ±2.8 vs 10.8 ±3.0 P 〈 0 05）,hs-CRP of atorvastatin group improved 3 months after treatment,and it improved much significantly 12 months after treatment compared with control group（3.02±0.43 vs 4.73 ±0.68 P 〈 0 05）,.Conclusion Atorvastatin can improves left ventricular diastolic function in patients with HFPEF,relieve their clinical symptoms,maybe can improve prognosis.