阿托伐他汀对2型糖尿病心肌病患者心功能、脑钠肽、超敏C反应蛋白影响临床研究
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摘要
目的:探讨阿托伐他汀对2型糖尿病心肌病心功能、脑钠肽(BNP)及超敏C反应蛋白(hs-CRP)的影响。方法:将59例2型糖尿病心肌病患者随机分为一般治疗组(n=29例)和阿伐他汀治疗组(n=30例),一般治疗组和阿伐他汀治疗组在治疗中严格控制血糖及给予抗心衰规范化治疗,阿伐他汀治疗组在此治疗基础上,加用阿伐他汀(20mg/d)治疗。所有患者在治疗前和治疗8周后,左室射血分数(LVEF)、检测左室舒张末期内径(LVDd)、血浆脑钠肽前体检氨基端片段(BNP)和血清超敏C反应蛋白(hs-CRP)。结果:两组患者在治疗前LVEF、LVDd、BNP及hs-CRP差异均无统计学意义(P>0.05),经8周治疗后,一般治疗组和阿托伐他汀治疗组,LVEF较治疗前明显改善(P<0.05),BNP及HS-CRP水平较治疗前明显降低(P<0.05),但LVDd未见明显改善(P>0.05),两组患者在治疗后,阿托伐他汀治疗组较一般治疗组BNP及hs-CRP明显降低(P<0.05),但LVEF和LVDd没有显著变化(P>0.05)。结论:阿托伐他汀改善糖尿病心肌病心功能,可能与降低血浆中脑钠肽水平及炎症因子相关。
Objective:To investigate the effect of atorvastatin on cardiacfunction,brain natriuretic peptide and hypersensitive C-reactive protein in patients with diabetic cardiomyopathies.Methods:Fifty-nine patients with diabetic cardiomyopathies were randomized into 2 groups:the control group(n=29)and theatorvastatin intervention group(n=30).Management of blood glucose and heart failure was performed in the 2 groups,with atorvastatin(20 mg/d)added to the patients in the intervention group.Left ventricular ejection fraction(LVEF),left ventricular end diastolicdiameter(LVDd),BNP and hs-CRP measurement was performed in every patient before and 8 weeks after initiation of the study.Results:There were no significant differences in the LVEF,LVDd,BNP,hs-CRP before treatment(P>0.05).After 8 weeks of treatment,the proportion of LVEF,plasma BNP and hs-CRP were significantly relieved inintervention group and control group(P<0.05).However,there were no significant differences in the LVDd(P>0.05).Moreover,the levels of BNP and hs-CRP were significantly decreased in intervention group after treatment(P<0.05),however,there were no significant differences in the LVEF and LVDd(P>0.05),compared to the control group.Conclusions:Atorvastatin improves the heart function of the patients,which probably related to the decreases of hs-CRP and BNP levels in patients with diabetic cardiomyopathies.
Objective:To investigate the effect of atorvastatin on cardiacfunction,brain natriuretic peptide and hypersensitive C-reactive protein in patients with diabetic cardiomyopathies.Methods:Fifty-nine patients with diabetic cardiomyopathies were randomized into 2 groups:the control group(n=29)and theatorvastatin intervention group(n=30).Management of blood glucose and heart failure was performed in the 2 groups,with atorvastatin(20 mg/d)added to the patients in the intervention group.Left ventricular ejection fraction(LVEF),left ventricular end diastolicdiameter(LVDd),BNP and hs-CRP measurement was performed in every patient before and 8 weeks after initiation of the study.Results:There were no significant differences in the LVEF,LVDd,BNP,hs-CRP before treatment(P>0.05).After 8 weeks of treatment,the proportion of LVEF,plasma BNP and hs-CRP were significantly relieved inintervention group and control group(P<0.05).However,there were no significant differences in the LVDd(P>0.05).Moreover,the levels of BNP and hs-CRP were significantly decreased in intervention group after treatment(P<0.05),however,there were no significant differences in the LVEF and LVDd(P>0.05),compared to the control group.Conclusions:Atorvastatin improves the heart function of the patients,which probably related to the decreases of hs-CRP and BNP levels in patients with diabetic cardiomyopathies.
引文
[1]Kain V,Halade GV.Metabolic and biochemical stressors in diabetic cardiomyopathy[J].Front Cardiovasc Med,2017,16(4):31.
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[4]卢树荣,黄之文,李飞.B型尿钠肽测定在糖尿病性心肌病早期诊断的价值[J].检验医学与临床,2014,11(7):962-963.
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[8]成永霞,张大伟,孙立新,等.肝X受体激动剂GW3965对高糖所致心肌细胞凋亡的影响及作用机制[J].陕西医学杂志,2017,46(7):819-822.
[9]张群雄.糖尿病心肌病患者血浆B型脑钠肽水平的变化[J].中外医学研究,2011,9(21):43-44.
[10]Ren XM,Zuo GF,Wu W,et al.Atorvastatin alleviates experimental diabetic cardiomyopathy by regulating the GSK-3beta-PP2Ac-NF-kappa B signaling axis[J].PLoSOne,2016,11(11):e0166740.
[11]Abdel-Hamid AA,Firgany Ael-D.Atorvastatin alleviates experimental diabetic cardiomyopathy by suppressing apoptosis and oxidative stress[J].J Mol Histol,2015,46(4-5):337-345.
[12]王丙聚,韩晓芳,郭爱红.阿托伐他汀钙联合血塞通注射液对糖尿病合并脑梗死患者血液流变指标和神经功能的影响[J].陕西医学杂志,2017,46(4):533-534.
[13]陈淼,武星,王国兴.阿托伐他汀对糖尿病心肌病患者心脏舒张功能的影响[J].中国慢性病预防与控制,2017,25(1):65-67.
[2]乔爱春,李扬,冯玫,等.血清N末端脑利钠肽前体及心肌营养素-1对糖尿病心肌早期诊断价值研究[J].中国药物与临床,2017,17(6):846-848.
[3]赵丽娟,王宪娟,崔振川.糖尿病心肌病的危险因素分析[J].临床合理用药杂志,2017,10(5):87-88.
[4]卢树荣,黄之文,李飞.B型尿钠肽测定在糖尿病性心肌病早期诊断的价值[J].检验医学与临床,2014,11(7):962-963.
[5]冯新星,陈燕燕.糖尿病心肌病的研究进展[J].中国循环杂志,2015,30(1):87-89.
[6]Ni R,Cao T,Xiong S,et al.Therapeutic inhibition of mitochondrial reactive oxygen species with mito-TEMPO reduces diabetic cardiomyopathy[J].Free Radic Biol Med,2016,90:12-23.
[7]Rubler S,Dlugash J,Yuceoglu YZ,et al.New type of cardiomyopathy associated with diabetic glomerulosclerosis[J].Am J Cardiol,1972,30(6):595-602.
[8]成永霞,张大伟,孙立新,等.肝X受体激动剂GW3965对高糖所致心肌细胞凋亡的影响及作用机制[J].陕西医学杂志,2017,46(7):819-822.
[9]张群雄.糖尿病心肌病患者血浆B型脑钠肽水平的变化[J].中外医学研究,2011,9(21):43-44.
[10]Ren XM,Zuo GF,Wu W,et al.Atorvastatin alleviates experimental diabetic cardiomyopathy by regulating the GSK-3beta-PP2Ac-NF-kappa B signaling axis[J].PLoSOne,2016,11(11):e0166740.
[11]Abdel-Hamid AA,Firgany Ael-D.Atorvastatin alleviates experimental diabetic cardiomyopathy by suppressing apoptosis and oxidative stress[J].J Mol Histol,2015,46(4-5):337-345.
[12]王丙聚,韩晓芳,郭爱红.阿托伐他汀钙联合血塞通注射液对糖尿病合并脑梗死患者血液流变指标和神经功能的影响[J].陕西医学杂志,2017,46(4):533-534.
[13]陈淼,武星,王国兴.阿托伐他汀对糖尿病心肌病患者心脏舒张功能的影响[J].中国慢性病预防与控制,2017,25(1):65-67.