目的研究普伐他汀聯(lián)合比索洛爾治療冠心病心力衰竭患者的療效及其對(duì)血清半乳糖凝聚素3（Gal-3）與卵泡抑素樣蛋白1（FSTL1）水平的影響。方法選取2017年8月-2019年8月于保定市第一醫(yī)院就診的100例冠心病心力衰竭患者作為研究對(duì)象，根據(jù)治療方法的差異將患者分為對(duì)照組和觀察組，每組各50例。對(duì)照組口服富馬酸比索洛爾片，初始劑量1.25 mg/d，1次/d，每周增加劑量1.25 mg，4周后增加劑量至7.5 mg/d，1次/d，維持治療。觀察組在對(duì)照組治療的基礎(chǔ)上口服普伐他汀鈉片，1片/次，1次/d。持續(xù)治療3個(gè)月。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的心功能指標(biāo)、血液流變學(xué)指標(biāo)和Gal-3、FSTL1水平。結(jié)果治療后，觀察組總有效率90.00%，明顯高于對(duì)照組的76.00%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的左室收縮末期內(nèi)徑（LVESD）、左心室舒張末期內(nèi)徑（LVEDD）及心率均顯著下降，左心射血分?jǐn)?shù)（LVEF）及6 min步行試驗(yàn)顯著升高（P<0.05）；且觀察組患者心功能改善情況優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者的全血高切黏度（HWBV）、全血低切黏度（LWBV）、血漿黏度（PV）值均較治療前顯著下降（P<0.05），且觀察組下降更明顯（P<0.05）。治療后，兩組血清腫瘤壞死因子α（TNF-α）、腦鈉肽（BNP）、超敏C反應(yīng)蛋白（hs-CRP）、Gal-3水平均下降，F(xiàn)STL1水平上升（P<0.05）；且觀察組細(xì)胞因子水平改善程度均優(yōu)于對(duì)照組（P<0.05）。結(jié)論普伐他汀聯(lián)合比索洛爾治療冠心病心力衰竭療效顯著，可以通過更好的降低血清Gal-3水平和提高FSTL1水平，調(diào)節(jié)炎性因子改善心功能，安全性較好。

Objective To study the effect of pravastatin combined with bisoprolol in treatment of coronary heart disease with heart failure, and the levels of serum Gal-3 and FSTL1. Methods A total of 100 patients with coronary heart disease with heart failure treated in the Baoding No. 1 Hospital from August 2017 to August 2019 were selected as the research objects. According to the difference in treatment methods, the patients were divided into control group and observation group, with 50 cases in each group. Patients in the control group were po administered with Bisoprolol Fumarate Tablets at an initial dose of 1.25 mg/d, once daily, and the dose was increased by 1.25 mg weekly, the dose was increased to 7.5 mg/d after four weeks, and the treatment was maintained. Patients in the observation group po administered with Pravastatin Sodium Tablets on the basis of control group, 1 tablet/time, once daily. The treatment was continued for 3 months. The clinical efficacy of two groups was observed, and the cardiac function indexes, hemorheology indexes, Gal-3 and FSTL1 levels were compared before and after treatment. Results After treatment, the total effective rate of observation group was 90.00%, which was significantly higher than 76.00% of control group, the difference was statistically significant (P < 0.05). After treatment, LVESD, LVEDD and heart rate in two groups were significantly decreased, while LVEF and 6-min walking test were significantly increased (P < 0.05). The improvement of cardiac function in observation group was better than those in control group (P < 0.05). After treatment, HWBV, LWBV and PV values in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more obvious in the observation group (P < 0.05). After treatment, the serum levels of TNF-α, BNP, hs-CRP, and Gal-3 were decreased in two groups, while the level of FSTL1 was increased (P < 0.05). The improvement of serum cytokine levels in observation group was better than that in control group (P < 0.05). Conclusion Pravastatin combined with bisoprolol has significant efficacy in treatment of coronary heart disease with heart failure. It can better reduce serum level of Gal-3 and FSTL1, regulate inflammatory factors and improve cardiac function, with good safety.

R972

保定市科學(xué)技術(shù)計(jì)劃項(xiàng)目（1941ZF029）