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目的:探讨普伐他汀对慢性心力衰竭(CHF)患者血浆C-反应蛋白(CRP)、N-末端脑钠素前体(NT-proBNP)水平和心功能的影响。方法:将90例CHF患者随机分为对照组(38例)和普伐他汀组(52例),对照组给予强心、利尿、扩血管治疗,普伐他汀组在此基础上加用普伐他汀10mg.d-1,疗程12周。采用改良Simpson法测定心衰患者治疗前后左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)。免疫比浊法测定血清C-反应蛋白(CRP)水平。采用酶联免疫法血浆NT-proBNP水平的变化。结果:两组患者治疗后LVEF和LVEDD水平较治疗前均明显改善(p<0.05);普伐他汀组LVEF由(36.2±3.5)%升至)45.6±4.8)%;血浆CRP浓度由(12.05±1.62)mg/L降至(6.43±1.35)mg/L;NT-proBNP浓度由(1198.7±312.2)fmol/ml降至(742.1±231.2)fmol/ml;TC由(5.60±0.63)mmol/L降至(4.03±0.41)mmol/L,与对照组比较差异均有统学意义(P<0.05)。且患者血浆NT-proBNP水平与LVEDD呈正相关(r=0.52,P<0.05),而与LVEF存在负相关(r=-0.63,P<0.05)。结论:CHF患者加用普伐他汀短期治疗可进一步改善心功能,降低CRP和NT-proBNP水平。
Objective: To investigate the effect of pravastatin on the levels of C-reactive protein (CRP), N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac function in patients with chronic heart failure (CHF). Methods: Ninety CHF patients were randomly divided into control group (n = 38) and pravastatin group (n = 52). Patients in control group were treated with cardiotomy, diuresis and vasodilator. Pravastatin group was given pravastatin Statin 10mg.d-1, treatment for 12 weeks. The left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) of patients with heart failure before and after treatment were measured by modified Simpson method. Serum C-reactive protein (CRP) levels were measured by immunoturbidimetry. Changes of plasma NT-proBNP levels by enzyme-linked immunosorbent assay. Results: The levels of LVEF and LVEDD in both groups were significantly improved after treatment (p <0.05); the LVEF in pravastatin group increased from (36.2 ± 3.5)% to (45.6 ± 4.8)%); the plasma CRP concentration increased from (12.05 ± (1.62 ± 1.72) fmol / ml and (5.60 ± 0.63) mmol / ml, respectively. The concentration of NT-proBNP decreased from (1198.7 ± 312.2) fmol / ml to (742.1 ± 231.2) L to (4.03 ± 0.41) mmol / L, all of which were significantly different from the control group (P <0.05). The plasma NT-proBNP level was positively correlated with LVEDD (r = 0.52, P <0.05), but negatively correlated with LVEF (r = -0.63, P <0.05). Conclusion: Short-term treatment with CHF in patients with pravastatin can further improve cardiac function and reduce the levels of CRP and NT-proBNP.