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目的观察阿托伐他汀对老年慢性心力衰竭(CHF)患者的治疗效果。方法 86例老年(>60岁)CHF患者,随机分为阿托伐他汀治疗组(47例)和对照组(39例),对照组给予强心、利尿、扩血管治疗,治疗组在此基础上加用阿托伐伐他汀,剂量为20mg,每晚1次,疗程6个月,随访心功能变化、心脏多普勒超声检查和检测血浆钠尿肽(BNP)水平。结果 6个月时治疗组心功能改善有效率与对照组相比差异有统计学意义。治疗组左室射血分数(LVEF)较对照组LVEF升高更明显(P<0·05)。入选患者在治疗前BNP水平均高于正常,治疗后血浆BNP水平均下降,但治疗组与对照组比较下降更明显(P<0·05)。两组患者血浆BNP水平与LVEF呈负相关(P<0·01)。结论长期应用阿托伐他汀可以改善老年CHF患者心功能和降低血浆BNP水平。
Objective To observe the therapeutic effect of atorvastatin on elderly patients with chronic heart failure (CHF). Methods A total of 86 elderly patients (> 60 years old) with CHF were randomly divided into atorvastatin group (n = 47) and control group (n = 39). The control group was treated with cardiotomy, diuretic and vasodilator. Atorvastatin was added at a dosage of 20 mg once a night for 6 months. Cardiac function, heart Doppler echocardiography and plasma BNP were measured. Results Six months after treatment, the improvement of cardiac function in the treatment group compared with the control group was statistically significant. The left ventricular ejection fraction (LVEF) in the treatment group was significantly higher than that in the control group (P <0.05). The BNP levels in the patients before treatment were all higher than those before the treatment, and the plasma BNP levels decreased after treatment. However, the treatment group decreased more obviously than the control group (P <0.05). Plasma BNP levels were negatively correlated with LVEF in both groups (P <0.01). Conclusion Long-term use of atorvastatin improves cardiac function and plasma BNP levels in elderly patients with CHF.