阿托伐他汀对慢性心力衰竭患者心功能及肿瘤坏死因子-α的影响.pdfVIP

内科急危重症杂志 2007年 第13卷 第6期 阿托伐他汀对慢性心力衰竭患者心功能及肿瘤坏死 因子一 的影响 四川省遂宁市人民医院 席海林 邓学军 赵咏梅，遂宁 629000 摘要 目的：探讨阿托伐他汀对慢性心力衰竭患者左室射血分数(LVEF)，脑利钠肽(BNP)及肿瘤坏死因子 (TNF-d)、核转录因子(NF-KB)活性的影响。方法：将血脂正常的慢性心力衰竭患者50例随机分为对照组(25例) 和他汀组(25例)。两组均接受常规治疗(利尿剂、ACEI、或洋地黄、 受体阻滞剂)，他汀组再加用阿托伐他汀(20 mg／d)治疗，治疗前及治疗后12周均测LVEF、血清BNP、TNF-d、外周血单个核细胞NF-KB活性。结果：BNP、 TNF-a、NF-KB活性与心力衰竭严重程度正相关，治疗 12周后，两组TNF-a、BNP、NF-KB活性均下降(P0．05)， LVEF升高(P0．05)，且以他汀组变化更明显，与对照组比较差异有统计学意义(P0．05)。结论：慢性心力衰竭 患者在接受常规治疗的同时，加用阿托伐他汀治疗可明显改善LVEF、降低BNP、TNF-d及NF-~B活性。 关键词 慢性心力衰竭 阿托伐他汀 肿瘤坏死因子一d 脑利钠肽 中图分类号 R542．1 文献标志码 A Effect of Atorvastatin on Cardiac Function and_l I 仅in Patients With Chronic Heart Failure Xj Hnilin．DENG Xuejun，ZHA0Yongmei． Ppeople’5 Hospital of Suining City，Suining 629000，China Abstract Objective：To investigate the effects of atorvastatin on left ventricular ejection fraction(LVEF)，brain natriuretic peptide(BNP)，TNF-d，nuclear factor-kappaB(NF-~B)activity in patients with chronic heart failure．Meth- ods：Fifty chronic heart failure patients with normal blood lipids were randomly divided into control group(n=25) and atorvastatln group(n=25)．Control group treated with routine therapy，atorvastatin group treated with atorvas- tatin based on routine therapy for 12 weeks．LVEF，BNP，TNF d and NF KB activity in peripheral blood monoeuclear cells(PBMC)were measured 1 2 weeks before and after treatment．Results：Levels of TNF-a，BNP and NF-KB activ— ity were significantly correlated with severity of cardiac function．Level of TNF d，BNP and NF KB activity were de- creased after 1 2 weeks’treatment(P0、05)．LvEF was increased compared with that before treatment in both groups，especially in atorvastatin group(PO．05)．Co nclusion：LVEF may be further improved while TNF d，BNP and NF-KB activity were further decreased in patients with chroni