目的 探討環(huán)磷腺苷聯(lián)合辛伐他汀治療慢性心力衰竭的臨床療效。方法 將天津市北辰醫(yī)院心血管內(nèi)科2012年9月—2014年9月收治的慢性心力衰竭患者120例,隨機(jī)分為治療組和對(duì)照組,每組各60例。對(duì)照組在常規(guī)治療的基礎(chǔ)上口服辛伐他汀片,10 mg/次,3次/d。治療組患者在對(duì)照組的基礎(chǔ)上靜脈滴注環(huán)磷腺苷葡胺注射液120 mg,1次/d。兩組均治療2周。比較兩組的臨床療效,心功能指標(biāo)左室射血分?jǐn)?shù)(LVEF)、最大血流速度比(E/A)、左室短軸縮短率(FS),血清因子腦鈉肽(BNP)、超敏C反應(yīng)蛋白(hs-CRP)、血尿酸(UA)、白細(xì)胞介素-6(IL-6)、腫瘤壞死因子(TNF-α),以及血脂水平三酰甘油(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)。結(jié)果 治療組總有效率(93.33%)明顯高于對(duì)照組(80.00%),兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05);治療后,兩組患者的LVEF、E/A、FS均較同組治療前明顯升高,且治療后治療組的相關(guān)指標(biāo)均高于同期對(duì)照組,比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);兩組患者的BNP、hs-CRP、UA、IL-6、TNF-α均顯著低于同組治療前(P< 0.05);治療后治療組的BNP、hs-CRP、UA、IL-6、TNF-α均低于同期對(duì)照組,比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05);治療后,兩組患者的TC、TG、LDL-C均較同組治療前顯著降低,HDL-C較同組治療前顯著升高(P< 0.05)。治療后,兩組患者的TC、TG、HDL-C、LDL-C比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 環(huán)磷腺苷聯(lián)合辛伐他汀治療慢性心力衰竭具有較好的臨床療效,改善患者的心功能,同時(shí)改善各種相關(guān)的血清因子指標(biāo)。

Objective To investigate the clinical effect of adenosine cyclophosphate combined with simvastatin in treatment of chronic heart failure. Methods Patients (120 cases) with chronic heart failure of Department of Cardiovascular Medicine in Tianjin Beichen Hospital from September 2012 to September 2012 were randomly divided into control and treatment groups. Each group had 60 cases. Patients in control group were po administered with Simvastatin Tablets on the basis of conventional therapy, 10 mg/time, three times daily. Patients in treatment group were iv Meglumine Adenosine Cyclophosphate Injections 120 mg on the basis of control group, once daily. The patients in two groups were treated for 2 weeks. The efficacy, cardiac function indicators left ventricular ejection fraction (LVEF), ratio of peak systolic velocity (E/A), shortening fraction (FS), serum factors brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP), blood uric acid (UA), interleukin 6 (IL-6), tumor necrosis factor-a (TNF-α), blood lipid levels triacylglycerol (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) were compared. Results The clinical efficacy in treatment group (93.33%) was higher than that in control group (80.00%) with significant difference (P < 0.05). After treatment, LVEF, E/A, and FS were significantly higher than those of same group before treatment. And LVEF, E/A, and FS in treatment group were higher than those in control group, and the difference was statistically significant (P < 0.05). BNP, hs-CRP, UA, IL-6, and TNF-α were significantly higher than those of same group before treatment. And BNP, hs-CRP, UA, IL-6, and TNF-α in treatment group after treatment were lower than those in control group with significant difference (P < 0.05). TC, TG, and LDL-C were significantly lower than those of same group before treatment,while HDL-C was higher than that of same group before treatment (P < 0.05). There was no significant difference in TC, TG, LDL-C, and HDL-C between two groups after treatment. Conclusion Adenosine cyclophosphate combined with simvastatin has good efficacy in treatment of chronic heart failure, and can greatly improve the cardiac function and serum factors of patients.