普伐他汀对急性心肌梗死急诊PCI术后慢性心力衰竭患者疗效的临床研究

目的观察他汀类药物普伐他汀对急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）术后慢性心力衰竭患者心功能、外周血肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、基质金属蛋白酶（MMP）-2等的影响。方法将112例AMI急诊PCI术后慢性心力衰竭（NYHA分级Ⅱ～Ⅲ级）患者随机分为普伐他汀20mg组（20mg组）和普伐他汀40mg组（40mg组）。收集患者基本资料，对患者进行心脏超声检查、基本实验室检查、特殊实验室检查（包括炎性因子、MMP-2）、6min步行试验（6-MWT）。随访18个月时再次进行治疗前的各项检测。结果与20mg组比较，40mg组治疗后6-MWT、左心室射血分数（LVEF）显著提高（P〈0．05）；40mg组TNF-d、IL-6、MMP-2治疗后下降水平差值更大（P〈0．05）；普伐他汀治疗后两组患者TNF-α、IL-6、MMP-2改变与总胆固醇，低密度脂蛋白降低之间没有显著相关性。结论普伐他汀对AMI急诊PCI术后慢性心力衰竭患者有益，且这种有益性独立于调脂作用之外。

Beneficial effect of Provastatin on patients with chronic heart failure who had been given PCI therapy after AMI

Objective To observe the effect of Provastatin on ventricular function, level of tumor necrosis factor （TNF）-α, interleukin（IL）-6, matrix metalloproteinases （MMP）-2 in patients with heart failure who had been given percutaneous coronary intervention （PCI） therapy after acute myocardial infarction （ AMI ）. Methods One hundred and twelve patients who had been given PCI after AMI were randomly administered with 20 mg Provastatin therapy（ 20 mg group） or 40 mg Provastatin therapy （40 mg group）. The baseline data of all patients were collected, and eehocardiography examination, special laboratory tests （including plasma inflammatory cytokines, MMP-2） and 6 rain walking test（6-MWT） were conducted before treatment and after 18 months follow-up. Results After therapy, 6-MWT, left ventrieular ejection fraction （LVEF） in 40 mg group were significantly higher than those in 20 mg group（ P 〈 0. 05 ） ; the level of TNF-α, IL-6, MMP-2 were more signif- icantly decreased in the 40 mg group. The changes of TNF-α, IL-6, MMP-2 level had no significant correlation with the decrease of total cholesterol, low density lipoprotein level. Conclusions Provastain showed beneficial effect for patients with heart failure who had been given PCI therapy after AMI, which was independent with cholesterol-lowering effect.