阿托伐他汀联合左卡尼汀治疗慢性心力衰竭疗效观察

目的：探讨阿托伐他汀联合左卡尼汀对慢性心力衰竭（chronic heart failure,CHF）患者心功能及细胞因子的影响。方法：将101例慢性心力衰竭患者随机分为对照组、阿托伐他汀组和联合治疗组,对照组行常规抗心力衰竭治疗,阿托伐他汀组在常规抗心力衰竭治疗的基础上加用阿托伐他汀,联合治疗组在常规抗心力衰竭治疗的基础上加用阿托伐他汀及左卡尼汀。所有患者在治疗前及治疗6周后检测血清C反应蛋白（CRP）、血浆脑利钠肽（BNP）,超声心动图检测左室射血分数（LVEF）和左室内径（LVEDD）。结果：与治疗前相比,各组治疗后CRP、BNP水平显著下降,LVEF、LVEDD明显改善（P〈0.05）,阿托伐他汀组及联合治疗组CRP、BNP水平下降较对照组更为显著（均P〈0.05）,LVEF、LVEDD改善较对照组明显,6min步行试验行走距离显著延长（P〈0.05）。与阿托伐他汀组相比,联合治疗组治疗后CRP、BNP水平差异及LVEF、LVEDD变化无统计学意义,但6min步行试验行走距离显著延长（P〈0.05）。结论：在常规治疗的基础上加用阿托伐他汀可进一步降低心力衰竭患者血液中CRP、BNP水平,发挥抗感染作用,同时改善患者心功能,阿托伐他汀联合左卡尼汀治疗,降低了心力衰竭患者的心肌耗氧,提高了患者的运动耐量。

Effects of atovastatin combined with levocanitine on chronic heart failure

Objective：To investigate the effects of atovastatin combined with levocanitine on chronic heart failure（CHF）.Methods：101 patients with CHF were randomly divided into three groups,control group treated with conventional therapy,atovastatin group treated with atovastatin based on conventional therapy,and combined treatment group treated with atovastatin and levocanitine based on conventional therapy.The parameters of cardiac function,including left ventricular ejection fraction（LVEF） and left ventricular end-diastolic diameter（LVEDD）,and the plasma 1evels of CRP and brain natriuretic peptide（BNP） were detected in all patients of each group before and after treatment.Results：There was significant difference in plasma levels of CRP and BNP,LVEF and LVEDD before and after treatment in all groups（P0.05）.As compared with control group after treatment,the plasma levels of CRP and BNP after treatment in both atovastatin group and combined treatment group were decreased markedly（P0.05）,so did LVEF,LVEDD and 6 min walk test（P0.05）.There was no significant difference in changes of CRP and BNP plasma levels,LVEF and LVEDD between atovastatin group and combined group after treatment（P0.05）,but 6 min walk test lengthened statistically in combined treatment group（P0.05）.Conclusion：Atovastatin based on conventional therapy may play a role in anti-inflammation by lowering the plasma levels of CRP and BNP in patients with CHF,thereby improving cardiac function.Atovastatin combined with levocanitine can reduce the cardiac muscular oxygen consumption and raise the excise endurance in patients with CHF.