摘要
目的研究阿托伐他汀对扩张型心肌病患者血清细胞因子水平及心功能的影响,探讨他汀类药物应用于非缺血性心肌病的可行性。方法69例心功能NYHAⅠ、Ⅱ级的扩张型心肌病患者随机分为2组。阿托伐他汀组(35例)每日口服立普妥20 mg,对照组(34例)不服用降脂药物。于实验开始及6个月结束时采用酶联免疫吸附法测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平;采用全自动免疫分析系统测定血清超敏C-反应蛋白(hs-CRP)水平,并测定血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)等水平的变化;通过超声心动图评价左心室舒张末期内径(LVEDD)、短轴缩短率(FS)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)及射血分数(EF)。结果①阿托伐他汀组较对照组TNF-α、IL-6、hs-CRP、TC、LDL-C水平及TC/HDL-C明显降低(均P<0.01);②阿托伐他汀组较对照组LVESV明显减低(P<0.05),而FS、EF明显增高(均P<0.01)。结论短期应用阿托伐他汀可以改善扩张型心肌病患者的心功能,降低血清炎性细胞因子和炎症标志物的水平。阿托伐他汀很可能成为治疗非缺血性心肌病的又一有效药物。
Objective To investigate the effect of atorvastatin on cytokines and cardiac function of patients with idiopathic dilated cardiomyopathy （ IDCM ） and to determine the feasibility of statins on nonischemic cardiomyopathy. Methods 69 dilated cardiomyopathy patients with NYHA Ⅰ-Ⅲ were randomly divided into 2 groups. Atorvastatin group（n = 35 ）received lipitor 20 mg per day and control group（n = 34） received no lipid-lowering drugs. At the beginning and after 6 months of the study the serum levels of tumor necrosis factor-α （ TNF-α ） and interleukin-6 （ IL-6 ） were measured with an enzyme-linked immunosorbent assay and the levels of high-sensitivity C-reactive protein （hs-CRP） were determined by an automatic immunoassay system, and the serum levels of total cholesterol （TC）, low density lipoprotein-cholesterol （LDL-C） , triglyceride （TG） were also assayed. Left ventricular end-diastolic dimension （ LVEDD ） , fractional shortening （FS） , left ventricular end-diastolic volume （LVEDV） , left ventricular end-systolic volume （LVESV） and ejection fraction （EF） were determined by echocardiography. Results （1） Compared with control group, the serum levels of TNF-α, IL-6, hs-CRP,TC, LDL-C in atorvastatin group were significantly decreased after treatment （ P 〈 0. 01 for each ）. （2） In atorvastatin group LVESV was significantly lower （P 〈 0.05 ）while FS and EF were significantly higher （P 〈 0.01 for each）than those in control group. Conclusion Short-term treatment with atorvastatin may improve the cardiac function of patients with IDCM and effectively decrease the serum level of cytokines and inflammatory markers. Atorvastatin has a good promise to become another effective treatment for nonischemic cardiomyopathy.
出处
《中国综合临床》
北大核心
2007年第8期673-675,共3页
Clinical Medicine of China
