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目的:观察阿托伐他汀对老年EF值降低型心力衰竭(HFr EF)的疗效及对左室重构和炎症因子的影响。方法:将80例老年HFr EF患者随机分为治疗组和对照组,每组40例。两组均给予常规抗心衰治疗,治疗组在此基础上每晚服用阿托伐他汀20 mg,1次/d,疗程均为6个月。测定治疗前、治疗后1、6个月血脂和肿瘤坏死因子-α(TNF-α)水平,并行超声心动图检测左心室射血分数(LVEF)和左心室舒张末期容积指数(LVEDVI)。结果:治疗后两组TNF-α水平均明显降低,治疗1个月时降幅最大,6个月时进一步降低,其中治疗组降幅更明显(P<0.05)。两组LVEF治疗1个月时均明显改善,持续至6个月,其中治疗组改善更明显(P<0.05)。治疗组治疗1个月时LVEDVI出现下降,6个月时降低更为显著,而对照组则在治疗6个月时LVEDVI才明显降低。结论:对于老年HFr EF,在常规抗心衰治疗基础上,加用阿托伐他汀能进一步降低血清TNF-α浓度,改善患者的心功能和心室重构。
Objective: To observe the effects of atorvastatin on left ventricular remodeling and inflammatory cytokines in elderly patients with congestive heart failure (HFr EF). Methods: Eighty elderly HFr EF patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given conventional anti-heart failure treatment, the treatment group on the basis of taking atorvastatin 20 mg, 1 time / d, every treatment for 6 months. The levels of serum lipids and tumor necrosis factor-α (TNF-α) were measured before and after treatment. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume index (LVEDVI) were measured by echocardiography. Results: After treatment, the levels of TNF-α in both groups were significantly decreased, with the largest declines at 1 month and the further declines at 6 months. The declines in the treatment group were more significant (P <0.05). The LVEF in both groups improved significantly at 1 month and continued to 6 months, and the treatment group improved more obviously (P <0.05). In the treatment group, LVEDVI decreased at 1 month and decreased more significantly at 6 months, while LVEDVI decreased significantly at 6 months in the control group. CONCLUSIONS: In elderly HFr EF, addition of atorvastatin can further decrease serum TNF-α concentration and improve cardiac function and ventricular remodeling in patients with conventional anti-heart failure treatment.