目的研究普伐他汀联合比索洛尔治疗冠心病心力衰竭患者的疗效及其对血清半乳糖凝聚素3（Gal-3）与卵泡抑素样蛋白1（FSTL1）水平的影响。方法选取2017年8月-2019年8月于保定市第一医院就诊的100例冠心病心力衰竭患者作为研究对象，根据治疗方法的差异将患者分为对照组和观察组，每组各50例。对照组口服富马酸比索洛尔片，初始剂量1.25 mg/d，1次/d，每周增加剂量1.25 mg，4周后增加剂量至7.5 mg/d，1次/d，维持治疗。观察组在对照组治疗的基础上口服普伐他汀钠片，1片/次，1次/d。持续治疗3个月。观察两组患者的临床疗效，同时比较两组治疗前后的心功能指标、血液流变学指标和Gal-3、FSTL1水平。结果治疗后，观察组总有效率90.00%，明显高于对照组的76.00%，差异有统计学意义（P<0.05）。治疗后，两组患者的左室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）及心率均显著下降，左心射血分数（LVEF）及6 min步行试验显著升高（P<0.05）；且观察组患者心功能改善情况优于对照组（P<0.05）。治疗后，两组患者的全血高切黏度（HWBV）、全血低切黏度（LWBV）、血浆黏度（PV）值均较治疗前显著下降（P<0.05），且观察组下降更明显（P<0.05）。治疗后，两组血清肿瘤坏死因子α（TNF-α）、脑钠肽（BNP）、超敏C反应蛋白（hs-CRP）、Gal-3水平均下降，FSTL1水平上升（P<0.05）；且观察组细胞因子水平改善程度均优于对照组（P<0.05）。结论普伐他汀联合比索洛尔治疗冠心病心力衰竭疗效显著，可以通过更好的降低血清Gal-3水平和提高FSTL1水平，调节炎性因子改善心功能，安全性较好。

Objective To study the effect of pravastatin combined with bisoprolol in treatment of coronary heart disease with heart failure, and the levels of serum Gal-3 and FSTL1. Methods A total of 100 patients with coronary heart disease with heart failure treated in the Baoding No. 1 Hospital from August 2017 to August 2019 were selected as the research objects. According to the difference in treatment methods, the patients were divided into control group and observation group, with 50 cases in each group. Patients in the control group were po administered with Bisoprolol Fumarate Tablets at an initial dose of 1.25 mg/d, once daily, and the dose was increased by 1.25 mg weekly, the dose was increased to 7.5 mg/d after four weeks, and the treatment was maintained. Patients in the observation group po administered with Pravastatin Sodium Tablets on the basis of control group, 1 tablet/time, once daily. The treatment was continued for 3 months. The clinical efficacy of two groups was observed, and the cardiac function indexes, hemorheology indexes, Gal-3 and FSTL1 levels were compared before and after treatment. Results After treatment, the total effective rate of observation group was 90.00%, which was significantly higher than 76.00% of control group, the difference was statistically significant (P < 0.05). After treatment, LVESD, LVEDD and heart rate in two groups were significantly decreased, while LVEF and 6-min walking test were significantly increased (P < 0.05). The improvement of cardiac function in observation group was better than those in control group (P < 0.05). After treatment, HWBV, LWBV and PV values in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more obvious in the observation group (P < 0.05). After treatment, the serum levels of TNF-α, BNP, hs-CRP, and Gal-3 were decreased in two groups, while the level of FSTL1 was increased (P < 0.05). The improvement of serum cytokine levels in observation group was better than that in control group (P < 0.05). Conclusion Pravastatin combined with bisoprolol has significant efficacy in treatment of coronary heart disease with heart failure. It can better reduce serum level of Gal-3 and FSTL1, regulate inflammatory factors and improve cardiac function, with good safety.

R972

保定市科学技术计划项目（1941ZF029）