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[摘要]
目的 探讨阿托伐他汀对慢性心衰患者NT-proBNP水平及氧化应激状态的影响。方法 选择2015年9月—2017年2月非缺血性心脏病慢性心衰患者102例,将所有患者随机分为对照组(n=51)和阿托伐他汀组(n=51)。对照组实施常规抗心衰药物治疗,阿托伐他汀组在常规抗心衰治疗基础上加用阿托伐他汀治疗,20 mg/d。两组疗程均为24周。观察并比较两组治疗前后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、NYHA分级、左室射血分数(LVEF)、NT-proBNP、6 min步行距离(6MWT)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、丙二醛(MDA)等指标。结果 阿托伐他汀组治疗后TG、TC、LDL-C水平明显下降,与治疗前及对照组比较,差异均有统计学意义(P<0.05)。两组患者治疗后NT-proBNP水平均有明显下降,与治疗前比较,差异有统计学意义(P<0.05),但阿托伐他汀组下降幅度优于对照组,组间比较差异有统计学意义(P<0.05)。与同组治疗前及对照组比较,阿托伐他汀组治疗后SOD明显增高,MDA、MPO明显下降,差异均有统计学意义(P<0.05);而对照组治疗前后无明显变化。结论 在常规抗心衰治疗的基础上加用阿托伐他汀,能有效降低CHF患者的NT-proBNP水平和抑制患者的氧化应激状态。
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[Abstract]
Objective To explore the influence of atorvastatin on N-terminal brain natriuretic peptide (NT-proBNP) and oxidative stress in patients with chronic heart failure (CHF). Methods 102 cases of chronic heart failure patients with non-ischaemic heart disease were chosen as chosen as the research objects. The patients were randomly divided into control group (n=51) and atorvastatin group (n=51). The patients were treated with the conventional drugs in control group, and combined with atorvastatin of 20 mg/d in atorvastatin group. All patients were treated for 12 weeks. Triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C), NYHA classification, left ventricular ejection fraction (LVEF), NT-proBNP, 6 min walking distance (6 MWT), SOD, MPO, MDA were observed and compared before and after treatment in two groups. Results Compared with before treatment and control group, TG, TC, LDL-C decreased obviously after treatment in atorvastatin group, the differences were statistically significant (P < 0.05). NT-proBNP levels decreased significantly after treatment in two groups, compared with that before treatment, the differences were statistically significant (P < 0.05), but the change in atorvastatin group was better than that in control group (P < 0.05). Compared with those before treatment and control group, SOD increased significantly, MDA, MPO decreased significantly after treatment in atorvastatin group, the differences were statistically significant (P < 0.05). The control group had no significant change before and after treatment. Conclusion The conventional anti-heart failure treatment added with atorvastatin could reduce effectively NT-proBNP level and inhibit oxidative stress in CHF patients.
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