三种剂量辛伐他汀分别联合曲美他嗪对慢性心力衰竭患者血清hs-CRP及心功能的效果对比

方敏

【摘要】 目的：探究三種剂量辛伐他汀分别联合曲美他嗪对慢性心力衰竭患者血清hs-CRP及心功能的效果对比。方法：选取2017年1月-2018年1月间到本院就诊的68例慢性心力衰竭患者，按照随机数字表法分为小剂量组（23例）、常规剂量组（23例）和大剂量组（22例）。三组患者均给予曲美他嗪治疗，小剂量组患者给予辛伐他汀10 mg/次，常规剂量组患者给予辛伐他汀20 mg/次，大剂量组患者给予辛伐他汀30 mg/次。连续治疗6个月后观察两组患者心功能指标、血清hs-CRP、TNF-α和IL-6、血脂指标以及临床疗效。结果：治疗后，各组患者LVEF均显著增高，LVDD和LVSD均显著减小，常规剂量组和大剂量组患者LVEF显著高于小剂量组，LVDD和LVSD显著低于小剂量组（P<0.05），但常规剂量组和大剂量组比较差异均无统计学意义（P>0.05）;各组患者血清hs-CRP、TNF-α和IL-6均降低，常规剂量组和大剂量组患者血清hs-CRP、TNF-α和IL-6均显著低于小剂量组（P<0.05），但常规剂量组和大剂量组比较差异均无统计学意义（P>0.05）;各组患者TC、TG和LDL-C均显著降低，HDL-C均显著增高，且常规剂量组和大剂量组患者TC、TG和LDL-C均显著低于小剂量组，HDL-C均显著高于小剂量组（P<0.05），但常规剂量组和大剂量组比较差异均无统计学意义（P>0.05）;常规剂量组的治疗总有效率91.30%和大剂量组95.45%显著高于小剂量组65.22%（P<0.05），但常规剂量组和大剂量组治疗总有效率比较差异无统计学意义（P>0.05）。结论：与小剂量辛伐他汀相比，常规剂量与大剂量辛伐他汀联合曲美他嗪能有效改善慢性心力衰竭患者心功能和血清hs-CRP，降低血脂，提高临床疗效，但大剂量辛伐他汀并不能提高临床疗效。

【关键词】 辛伐他汀; 曲美他嗪; 慢性心力衰竭; hs-CRP

【Abstract】 Objective：To compare the effects of three doses of Simvastatin combined with Trimetazidine on serum hs-CRP and cardiac function in patients with chronic heart failure.Method：68 patients with chronic heart failure in our hospital from January 2017 to January 2018 were selected and divided into small dose group（23 cases），routine dose group（23 cases）and large dose group（22 cases）.Three groups of patients were treated with Trimetazidine，small dose group was given Simvastatin 10 mg/times，while routine dose group with 20 mg/times，large dose group with 30 mg/times.After 6 months of continuous treatment，the cardiac function indexes，serum hs-CRP，TNF-α and IL-6，blood lipids and clinical efficacy were observed in the three groups.Result：After the treatment，the LVEF of all the groups increased significantly，and the LVDD and LVSD decreased significantly，the LVEF of the routine dose group and the large dose group were significantly higher than those of the small dose group，and the LVDD and LVSD were significantly lower than those in the small dose group（P<0.05），but there were no statistical differences between the routine dose group and the large dose group（P>0.05）.Serum hs-CRP，TNF-α and IL-6 decreased in all groups.The serum hs-CRP，TNF-α and IL-6 in the routine dose group and the large dose group were significantly lower than those in the small dose group（P<0.05），but there were no statistical differences between the routine dose group and the large dose group（P>0.05）.The levels of TC，TG and LDL-C were significantly decreased，and the HDL-C were significantly increased in all groups，the levels of TC，TG and LDL-C in the routine dose group and the large dose group were significantly lower than those in the small dose group，and the HDL-C was significantly higher than that of the small dose group（P<0.05），but there was no statistical difference between the conventional dose group and the large dose group（P>0.05）.The treatment effectiveness rate of the routine dose group and the large dose group was significantly higher than that of the small dose group（91.30%，95.45% vs 65.22%，P<0.05），but there were no significant differences between routine dose group and high-dose group（P>0.05）.Conclusion：Compared with low dose Simvastatin，conventional dose and large dose Simvastatin combined with Trimetazidine can effectively improve cardiac function and serum hs-CRP，reduce blood lipid and improve clinical efficacy in patients with chronic heart failure，but large dose of simvastatin can not improve the clinical efficacy.