辛伐他汀联合曲美他嗪对慢性心力衰竭患者的心功能、血管内皮功能的影响

万小强

【摘要】 目的：分析辛伐他汀聯合曲美他嗪与酒石酸美托洛尔缓释片对慢性心力衰竭患者的心功能、血管内皮功能的影响。方法：选取2019年1月-2020年6月抚州市妇幼保健院收治的98例慢性心力衰竭患者，根据随机数字表法将其分为对照组和研究组，每组49例。对照组给予酒石酸美托洛尔缓释片治疗，研究组则给予辛伐他汀联合曲美他嗪治疗。比较两组临床疗效及治疗前后的每搏输出量（SV）、6 min步行距离（6MWT）、血管内皮功能[一氧化氮（nitric oxide，NO）、一氧化氮合酶（nitric oxide synthase，NOS）、二甲基精氨酸（asymmetric dimethylarginine，ADMA）、血管舒张功能（flow-mediated dilation，FMD）]。结果：研究组总有效率为95.92%高于对照组的81.63%，差异有统计学意义（P<0.05）。治疗前，两组SV、6MWT比较，差异均无统计学意义（P>0.05）;治疗后，两组SV、6MWT均高于治疗前，且研究组高于对照组，差异均有统计意义（P<0.05）。治疗前，两组NO、NOS、ADMA、FMD比较，差异均无统计学意义（P>0.05）;治疗后，对照组NO、NOS、ADMA、FMD与治疗前比较，差异均无统计学意义（P>0.05）。治疗后，研究组NO、NOS、FMD均高于治疗前，ADMA低于治疗前，差异均有统计学意义（P<0.05）。治疗后，两组NO、NOS、ADMA、FMD比较，差异均有统计学意义（P<0.05）。结论：辛伐他汀联合曲美他嗪治疗慢性心力衰竭的效果较好，可以有效地改善患者地心功能及血管内皮功能，值得推广使用。

【关键词】 辛伐他汀 曲美他嗪 慢性心力衰竭 血管内皮功能

Effects of Simvastatin Combined with Trimetazidine on Cardiac Function and Vascular Endothelial Function in Patients with Chronic Heart Failure/WAN Xiaoqiang. //Medical Innovation of China， 2021， 18（27）： 0-036

[Abstract] Objective： To analyze the effects of Simvastatin combined with Trimetazidine and Metoprolol Tartrate Sustained-release Tablets on cardiac function and vascular endothelial function in patients with chronic heart failure. Method： A total of 98 patients with chronic heart failure admitted to Fuzhou Maternal and Child Health Hospital from January 2019 to June 2020 were selected， they were divided into control group and study group according to random number table method， 49 cases in each group. The control group was treated with Metoprolol Tartrate Sustained-Release Tablets， the study group was treated with Simvastatin combined with Trimetazidine. The clinical efficacy was compared between two groups， SV， 6 min walking distance （6MWT）， vascular endothelial function [nitric oxide （NO）， nitric oxide synthase （NOS） and asymmetric dimethylarginine （ADMA）， flow-mediated dilation （FMD）] before and after treatment were compared between two groups. Result： The total effective rate of the study group was 95.92%， which was higher than 81.63% of the control group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in SV and 6MWT between two groups （P>0.05）; after treatment， SV and 6MWT of both groups were higher than those before treatment， and those of the study group were higher than those of the control group， the differences were statistically significant （P<0.05）. Before treatment， there were no significant differences in NO， NOS， ADMA and FMD between two groups （P>0.05）. After treatment， there were no significant differences in NO， NOS， ADMA and FMD of the control group compared with those before treatment （P>0.05）. After treatment， the NO， NOS and FMD of the study group were higher than those before treatment， while ADMA was lower than that before treatment， the differences were statistically significant （P<0.05）. After treatment， there were statistically significant differences in NO， NOS， ADMA and FMD between two groups （P<0.05）. Conclusion： Simvastatin combined with Trimetazidine has a good effect in the treatment of chronic heart failure， which can effectively improve the cardiac function and vascular endothelial function of patients， and is worthy of popularization.

[Key words] Simvastatin Trimetazidine Chronic heart failure Vascular endothelial function

First-author’s address： Fuzhou Maternal and Child Health Hospital， Fuzhou 344100， China

doi：10.3969/j.issn.1674-4985.2021.27.009

心力衰竭是指在慢性心脏疾病的基础上，逐渐出现心脏泵血功能降低，心脏在足够静脉回流条件下，心搏出量仍不足以满足机体代谢需要，或者有赖于充盈压升高来补偿的病理状态，而慢性心力衰竭则是除了发作性的急性心衰以外的持续心衰状态[1]。……