不同剂量阿托伐他汀治疗心梗后无症状心衰疗效对比研究.docVIP

不同剂量阿托伐他汀治疗心梗后无症状心衰的疗效对比研究 　　[摘要] 目的 探讨不同剂量阿托伐他汀治疗心梗后无症状心衰的临床效果。 方法 将2013年5月～2015年5月入住我院的112例心梗后SHF患者按照不同给药剂量随机分为对照组（n=56）与研究组（n=56），两组患者均首先给予常规治疗，然后在此基础上给予不同剂量的阿托伐他汀治疗，对照组给药剂量为20 mg/d，研究组为40 mg/d。比较两组患者治疗前后心功能指标、血浆BNP及 hs-CRP水平。结果 ①两组患者治疗后LVESD水平较治疗前均显著降低（P0.05），且研究组显著低于对照组（P0.05）；两组患者治疗后LVEF 显著升高（P0.05～0.01），且研究组显著高于对照组（P0.05）；②两组患者治疗后血浆BNP及 hs-CRP水平显著降低（P0.01），且研究组显著低于对照组（P0.05）。 结论 阿托伐他汀治疗心梗后无症状心衰的疗效显著，且给药剂量为40 mg/d治疗疗效较20 mg/d更为显著。 　　[关键词] 心肌梗死；无症状心衰；阿托伐他汀；心功能 　　[中图分类号] R542.22 [文献标识码] B [文章编号] 1673-9701（2016）16-0032-03 　　[Abstract] Objective To study the clinical effects of different doses atorvastatin in treatment of myocardial infarction with asymptomatic heart failure. Methods In our hospital，112 cases of myocardial infarction SHF from May 2013 to May 2015 were randomly divided into control group（n=56） and study group（n=56）， both groups were given conventional treatment，and then given different doses atorvastatin on basis of conventional treatment，control group was 20 mg/d，study group was 40 mg/d. The cardiac function，the plasma BNP and hs-CRP levels were compared before and after treatment. Results ①After treatment，LVESD level was significantly lower than before treatment（P0.05）， the study group was significantly lower than the control group（P0.05）； After treatment，the LVEF was significantly increased than before treatment（P0.05），and the study group was significantly higher than the control group（P0.05）； ②BNP and serum hs-CRP was decreased significantly than before treatment，and the study group was significantly higher than the control group（P0.05）. Conclusion Atorvastatin in treatment of asymptomatic heart failure after myocardial infarction have significant effect，and the dose of 40 mg/d treatment is more significant effect than the 20 mg/d. 　　[Key words] Myocardial infarction； Asymptomatic heart failure； Atorvastatin； Cardiac function 　　无症状心衰（silent heart failure，SHF）指的是无心肌缺血、呼吸窘迫、胸痛以及胸闷等方面的临床表现，但是显示存在左心室功能障碍[1]。大量临床研究证实[2-4]，心肌梗死后的患者合并心力衰竭的发病率较高