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目的探讨辛伐他汀联合环磷腺苷治疗冠心病慢性心力衰竭的疗效,及对相关血清因子水平的影响,为慢性心力衰竭的治疗提供依据。方法选择于2014年1月至2016年2月在北京市昌平区医院诊治的冠心病慢性心力衰竭患者130例作为研究对象,应用随机数字表法随机分为联合治疗组与对照组。两组患者均先给予常规内科综合治疗。在此基础上,对照组给予辛伐他汀治疗,联合治疗组给予辛伐他汀联合环磷腺苷葡胺治疗,两组患者均治疗14 d。比较两组患者的临床疗效,心功能指标及相关血清因子的变化情况。应用SPSS 17.0软件包进行数据的统计处理。结果联合治疗组总有效率为86.15%,对照组为67.69%,两组临床疗效的差异有统计学意义(P<0.05)。治疗前,两组患者左室射血分数(LVEF)、心输出量(CO)、舒张早期峰值速度/舒张晚期峰值速度(E/A)的差异无统计学意义(P>0.05);治疗后,两组LVEF、CO、E/A均较同组治疗前明显升高,差异均有统计学意义(P<0.05),且两组间3个指标的差异亦具有统计学意义(P<0.05)。治疗前,两组患者氨基末端-B型脑钠肽(NT-pro BNP)、C反应蛋白(CRP)及白细胞介素(IL)-6的差异均无统计学意义(P>0.05);治疗后,两组患者的NT-pro BNP、CRP及IL-6均较治疗前明显下降,差异均有统计学意义(P<0.05),且两组间各指标的差异亦均有统计学意义(P<0.05)。结论辛伐他汀联合环磷腺苷对冠心病慢性心力衰竭具有良好的临床疗效,并降低血清相关炎症因子水平。
Objective To investigate the curative effect of simvastatin combined with cyclic adenosine monophosphate on chronic heart failure with coronary heart disease and its effect on the serum levels of related factors to provide the basis for the treatment of chronic heart failure. Methods From January 2014 to February 2016, 130 patients with coronary heart disease and chronic heart failure (CHD) diagnosed and treated in Changping District Hospital of Beijing were enrolled and randomly divided into combined treatment group and control group by random number table. Two groups of patients were given general internal medicine treatment. On this basis, the control group was treated with simvastatin, and the combination therapy group was given Simvastatin combined with cyclic adenosine monophosphate. Both groups were treated for 14 days. The clinical efficacy, cardiac function and related serum factors in two groups were compared. SPSS 17.0 software package for statistical data processing. Results The total effective rate was 86.15% in the combined treatment group and 67.69% in the control group, the difference was statistically significant (P <0.05). Before treatment, LVEF, CO, peak early diastolic velocity / late diastolic peak velocity (E / A) had no significant difference between the two groups (P> 0.05); after treatment , LVEF, CO, E / A in both groups were significantly higher than those in the same group before treatment (P <0.05), and the differences of the three indexes between the two groups were also statistically significant (P <0.05 ). There was no significant difference in the levels of NT-proBNP, CRP and IL-6 between the two groups before treatment (P> 0.05). Treatment After treatment, the levels of NT-pro BNP, CRP and IL-6 in both groups were significantly lower than those before treatment (all P <0.05), and there was significant difference between the two groups P <0.05). Conclusion Simvastatin combined with cyclic adenosine monophosphate has a good clinical effect on chronic heart failure with coronary heart disease and reduces serum levels of inflammatory cytokines.