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目的探讨辛伐他汀对慢性心力衰竭(CHF)患者的安全性和高敏C-反应蛋白的影响。方法65例CHF患者随机分为对照组和辛伐他汀组,治疗前及治疗后1周、2周、4周抽血查血脂、肝、肾功能及hs-CRP等指标。结果辛伐他汀组用药后第1周丙氨酸氨基转移酶(ALT)出现异常的高峰期,异常例数比对照组多(P<0.05);多数ALT<3倍正常值,观察2周后恢复正常;而对照组有1例(1/30,3.3%)。辛伐他汀组有2例(2/32,6.3%),患者ALT升高>3倍正常值,需停用辛伐他汀,两组ALT升高>3倍者无统计学差异;两组各有2例肾功能异常,无需停药;肌酐及CK改变在两组患者无显著差异;胃肠道反应出现无统计学差异;未见有精神症状、过敏、肌肉酸痛等现象。两组治疗前后血脂成分的变化无显著性差异,而辛伐他汀组治疗1周后血浆hs-CRP即开始降低,与治疗前比较有统计学差异(P<0.05),与对照组同期比较有统计学差异(P<0.05)。结论辛伐他汀10mg/d在CHF患者的应用是安全的,辛伐他汀早期治疗可明显降低hs-CRP的水平,与血脂TC、LDL-C下降无相关性,说明他汀类药物治疗心力衰竭是通过调脂以外起作用,可能对心力衰竭患者的治疗带来益处。
Objective To investigate the effect of simvastatin on the safety and high-sensitivity C-reactive protein in patients with chronic heart failure (CHF). Methods Sixty-five CHF patients were randomly divided into control group and simvastatin group. Blood lipid, liver and renal function, hs-CRP and other indexes were determined before treatment, 1 week, 2 weeks and 4 weeks after treatment. Results In the simvastatin group, the abnormal peak of alanine aminotransferase (ALT) appeared in the first week after treatment, with more abnormal cases than the control group (P <0.05); most ALT <3 times normal, Returned to normal; while the control group, 1 case (1 / 30,3.3%). Simvastatin group 2 cases (2 / 32,6.3%), patients with ALT increased> 3 times normal, need to disable simvastatin, two groups of ALT increased> 3 times no significant difference between the two groups There are 2 cases of renal dysfunction, no withdrawal; creatinine and CK changes in the two groups of patients no significant difference; gastrointestinal reactions showed no significant difference; no mental symptoms, allergies, muscle soreness and so on. Serum hs-CRP began to decrease in the simvastatin group after 1 week of treatment, with statistical significance (P <0.05), compared with the control group over the same period Statistical difference (P <0.05). Conclusion Simvastatin 10 mg / d is safe for patients with CHF. Early treatment with simvastatin can significantly reduce the level of hs-CRP, but not with the decrease of blood lipid TC and LDL-C, indicating that statin treatment of heart failure is By acting outside of lipid regulation, it may benefit the treatment of heart failure patients.