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目的对比分析阿托伐他汀与瑞舒伐他汀治疗慢性心衰(CHF)合并中枢性睡眠呼吸暂停(CSA)的疗效,为临床治疗提供参考依据。方法选取2013年3月至2017年5月在河北省廊坊市第四人民医院住院治疗的106例CHF合并CSA患者为研究对象,随机分为A、B两组,每组53例。A组给予阿托伐他汀20 mg/d,B组给予瑞舒伐他汀10 mg/d,疗程均为6个月。测定两组患者治疗前后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血肌酐(SCr)、超敏C-反应蛋白(hs-CRP)和N端前体脑钠肽(NT-Pro BNP)水平。采用彩色多普勒超声显像仪测量左室舒张末内径(LVEDD)、左室射血分数(LVEF)。采用多导睡眠监测仪,记录睡眠呼吸暂停低通气指数(AHI)、觉醒次数。用SPSS 17.0软件包进行配对t检验、独立样本t检验和χ2检验。结果治疗后,两组患者TC、TG、LDL-C和hs-CRP水平与治疗前比较均明显下降,差异均有统计学意义(P<0.05),且B组TC、TG水平与A组比较明显下降,差异均有统计学意义(P<0.05)。两组患者治疗后ALT、AST和SCr水平无明显变化,差异均无统计学意义(P>0.05)。治疗后,两组患者NT-Pro BNP、LVEDD与治疗前比较明显降低,差异均有统计学意义(P<0.05),而LVEF与治疗前比较明显升高,差异均有统计学意义(P<0.05)。治疗后,两组患者AHI及觉醒次数较治疗前明显降低,差异均有统计学意义(P<0.05),并且A组治疗后AHI及觉醒次数较B组明显降低,差异均有统计学意义(P<0.05)。结论阿托伐他汀治疗可明显改善CHF合并CSA患者的心功能及睡眠呼吸状况,阿托伐他汀对于CSA的疗效优于瑞舒伐他汀。
Objective To compare and analyze the curative effect of atorvastatin and rosuvastatin on chronic heart failure (CHF) combined with central sleep apnea (CSA), so as to provide reference for clinical treatment. Methods From March 2013 to May 2017, 106 CHF patients with CSA admitted to the Fourth People’s Hospital of Langfang City, Hebei Province were enrolled in this study. Patients were randomly divided into A and B groups, with 53 patients in each group. Group A received atorvastatin 20 mg / d and group B received rosuvastatin 10 mg / d for 6 months. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) , Serum creatinine (SCr), high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-Pro BNP) Left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured by color Doppler sonography. Using polysomnography, sleep apnea-hypopnea index (AHI) and number of awakenings were recorded. Paired t-test with SPSS 17.0 software package, independent sample t-test and χ2 test. Results After treatment, the levels of TC, TG, LDL-C and hs-CRP in both groups were significantly lower than those before treatment (P <0.05), and the levels of TC and TG in group B were significantly lower than those in group A Significantly decreased, the differences were statistically significant (P <0.05). There was no significant difference in the levels of ALT, AST and SCr between the two groups after treatment (P> 0.05). After treatment, NT-Pro BNP and LVEDD were significantly decreased in both groups (P <0.05), while LVEF was significantly higher than that before treatment (P < 0.05). After treatment, the number of AHI and awakening in both groups were significantly lower than those before treatment (P <0.05), and the number of AHI and awakening in group A was significantly lower than that in group B after treatment (P <0.05) P <0.05). Conclusions Atorvastatin treatment can significantly improve cardiac function and sleep breathing in CHF patients with CSA. Atorvastatin is superior to rosuvastatin in the treatment of CSA.