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目的探讨二丁酰环磷腺苷钙联合瑞舒伐他汀对射血分数保留的慢性心力衰竭(HF-PEF)患者心功能及N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)的影响。方法选取2014年10月—2015年10月宿迁市第一人民医院收治的HF-PEF患者80例,随机分为对照组和观察组,每组40例。对照组患者给予常规治疗,观察组患者在常规治疗基础上给予二丁酰环磷腺苷钙联合瑞舒伐他汀;两组患者均连续治疗2周。比较两组患者治疗前和治疗2周后的心功能指标[左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、6分钟步行距离、美国纽约心脏病协会(NYHA)分级]、NT-proBNP、hs-CRP,临床疗效及不良反应发生情况。结果治疗前两组患者LVESV、LVEDV、LVEF、6分钟步行距离、NYHA分级比较,差异无统计学意义(P>0.05);治疗后观察组患者LVESV、NYHA分级低于对照组,LVEDV、LVEF高于对照组,6分钟步行距离长于对照组(P<0.05);治疗后两组患者LVESV、NYHA分级低于治疗前,LVEDV、LVEF高于治疗前,6分钟步行距离长于治疗前组(P<0.05)。治疗前两组患者NT-proBNP、hs-CRP比较,差异无统计学意义(P>0.05);治疗后观察组患者NT-proBNP、hs-CRP低于对照组(P<0.05);治疗后两组患者NT-proBNP、hs-CRP低于治疗前(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论二丁酰环磷腺苷钙联合瑞舒伐他汀可有效改善HF-PEF患者心功能,降低NT-pro BNP、hs-CRP,有利于延缓心室重构。
Objective To investigate the relationship between heart function, N-terminal pro-brain natriuretic peptide (NT-proBNP) and hypersensitive C-reactive protein in patients with chronic heart failure (HF-PEF) with ejection fraction preserved by calcium dibutyryl adenosine monophosphate and rosuvastatin hs-CRP). Methods Eighty HF-PEF patients admitted to the First People’s Hospital of Suqian from October 2014 to October 2015 were randomly divided into control group and observation group, 40 cases in each group. Patients in the control group were given routine treatment. The patients in the observation group were given calcium biliary adenosine monophosphate combined with rosuvastatin on the basis of conventional treatment. Patients in both groups were treated continuously for two weeks. The cardiac function indexes (left ventricular end systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), 6 minute walking distance before and 2 weeks after treatment were compared between two groups. Heart Association (NYHA) classification], NT-proBNP, hs-CRP, clinical efficacy and adverse reactions. Results There was no significant difference in LVESV, LVEDV, LVEF, 6-minute walking distance and NYHA classification between the two groups before treatment (P> 0.05). LVESV and NYHA in the observation group were lower than those in the control group, LVEDV and LVEF In the control group, the 6-minute walking distance was longer than that of the control group (P <0.05). The LVESV and NYHA scores of the two groups were lower than those before treatment, LVEDV and LVEF were higher than those before treatment and 6-minute walking distance longer than those before treatment (P < 0.05). The levels of NT-proBNP and hs-CRP in the two groups before treatment were no significant difference (P> 0.05). After treatment, NT-proBNP and hs-CRP in the observation group were lower than those in the control group (P <0.05) Group NT-proBNP, hs-CRP lower than before treatment (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion Calcium dibutyryl adenosine monophosphate combined with rosuvastatin can effectively improve the cardiac function, reduce the NT-pro BNP and hs-CRP in HF-PEF patients, and delay the ventricular remodeling.