目的 探讨环磷腺苷联合辛伐他汀治疗慢性心力衰竭的临床疗效。方法 将天津市北辰医院心血管内科2012年9月—2014年9月收治的慢性心力衰竭患者120例,随机分为治疗组和对照组,每组各60例。对照组在常规治疗的基础上口服辛伐他汀片,10 mg/次,3次/d。治疗组患者在对照组的基础上静脉滴注环磷腺苷葡胺注射液120 mg,1次/d。两组均治疗2周。比较两组的临床疗效,心功能指标左室射血分数(LVEF)、最大血流速度比(E/A)、左室短轴缩短率(FS),血清因子脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、血尿酸(UA)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α),以及血脂水平三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。结果 治疗组总有效率(93.33%)明显高于对照组(80.00%),两组比较差异具有统计学意义(P< 0.05);治疗后,两组患者的LVEF、E/A、FS均较同组治疗前明显升高,且治疗后治疗组的相关指标均高于同期对照组,比较差异有统计学意义(P< 0.05);两组患者的BNP、hs-CRP、UA、IL-6、TNF-α均显著低于同组治疗前(P< 0.05);治疗后治疗组的BNP、hs-CRP、UA、IL-6、TNF-α均低于同期对照组,比较差异有统计学意义(P< 0.05);治疗后,两组患者的TC、TG、LDL-C均较同组治疗前显著降低,HDL-C较同组治疗前显著升高(P< 0.05)。治疗后,两组患者的TC、TG、HDL-C、LDL-C比较差异无统计学意义。结论 环磷腺苷联合辛伐他汀治疗慢性心力衰竭具有较好的临床疗效,改善患者的心功能,同时改善各种相关的血清因子指标。

Objective To investigate the clinical effect of adenosine cyclophosphate combined with simvastatin in treatment of chronic heart failure. Methods Patients (120 cases) with chronic heart failure of Department of Cardiovascular Medicine in Tianjin Beichen Hospital from September 2012 to September 2012 were randomly divided into control and treatment groups. Each group had 60 cases. Patients in control group were po administered with Simvastatin Tablets on the basis of conventional therapy, 10 mg/time, three times daily. Patients in treatment group were iv Meglumine Adenosine Cyclophosphate Injections 120 mg on the basis of control group, once daily. The patients in two groups were treated for 2 weeks. The efficacy, cardiac function indicators left ventricular ejection fraction (LVEF), ratio of peak systolic velocity (E/A), shortening fraction (FS), serum factors brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP), blood uric acid (UA), interleukin 6 (IL-6), tumor necrosis factor-a (TNF-α), blood lipid levels triacylglycerol (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) were compared. Results The clinical efficacy in treatment group (93.33%) was higher than that in control group (80.00%) with significant difference (P < 0.05). After treatment, LVEF, E/A, and FS were significantly higher than those of same group before treatment. And LVEF, E/A, and FS in treatment group were higher than those in control group, and the difference was statistically significant (P < 0.05). BNP, hs-CRP, UA, IL-6, and TNF-α were significantly higher than those of same group before treatment. And BNP, hs-CRP, UA, IL-6, and TNF-α in treatment group after treatment were lower than those in control group with significant difference (P < 0.05). TC, TG, and LDL-C were significantly lower than those of same group before treatment,while HDL-C was higher than that of same group before treatment (P < 0.05). There was no significant difference in TC, TG, LDL-C, and HDL-C between two groups after treatment. Conclusion Adenosine cyclophosphate combined with simvastatin has good efficacy in treatment of chronic heart failure, and can greatly improve the cardiac function and serum factors of patients.