汪丽丽 贺钰梅 郝春举

[摘要] 目的 探討瑞舒伐他汀联合辅酶Q10治疗慢性心衰后血清炎性指标、血清脑钠肽及心功能的变化。 方法 选择2014年1月～2015年2月在延安大学附属医院东关分院进行治疗的慢性心衰患者96例，根据随机数字表法分为观察组和对照组，每组各48例，对照组患者在常规治疗措施的基础上给予瑞舒伐他汀治疗；观察组在常规治疗措施的基础上加用瑞舒伐他汀和辅酶Q10治疗。对两组患者治疗前后血清炎性指标、血清脑钠肽及心功能的变化进行评估。 结果 观察组患者有效率显著高于对照组（P < 0.05）。治疗后观察组患者左心室舒张末期内径（LVEDD），左心室收缩末期内径（LVESD）均显著低于对照组（P < 0.05），治疗后观察组患者左心室射血分数（LVEF）显著高于对照组（P < 0.05）。治疗后观察组心功能分级和BNP水平均显著低于对照组（P < 0.05），观察组患者6 min步行距离显著高于对照组（P < 0.05）。治疗后观察组患者超敏C反应蛋白（hs-CRP），肿瘤坏死因子-α（TNF-α）和白介素-6（IL-6）水平均显著低于对照组（P < 0.05）。 结论 瑞舒伐他汀联合辅酶Q10能够显著降低慢性心衰后血清炎性指标和血清脑钠肽水平，并能有效改善患者心功能，可在临床推广应用。

[关键词] 瑞舒伐他汀；辅酶Q10；慢性心衰；血清炎性指标；血清脑钠肽；心功能

[中图分类号] R541.6+1 [文献标识码] A [文章编号] 1673-7210（2016）02（c）-0166-04

Effect of rosuvastatin combined with coenzyme Q10 on serum inflammatory indexes， changes of serum brain natriuretic peptide and cardiac function of patients with chronic heart failure

WANG Lili1 HE Yumei2 HAO Chunju3

1.General Medicine Department， Dongguan Branch， the Affiliated Hospital of Yan'an University， Shaanxi Province， Yan'an 716000， China； 2.Ophthalmology Department， Yan'an Bo'ai Hospital， Shaanxi Province， Yan'an 716000， China

[Abstract] Objective To investigate the effect of rosuvastatin combined with coenzyme Q10 on serum inflammatory indexes， variation of serum brain natriuretic peptide， cardiac function of patients with chronic heart failure. Methods 96 patients with chronic heart failure treated in Dongguan Branch of Affiliated Hospital of Yan'an University from January 2014 to February 2015 were randomly divided into observation group and control group according to the random number table， with 48 cases in each grop. The control group patients were treated with rosuvastatin based on conventional treatment. The observation group were treated with rosuvastatin and coenzyme Q10 based on routine treatment. The inflammatory index， variation of serum brain natriuretic peptide and cardiac function were evaluated before and after treatment. Results The efficiency rate in observation group was significantly higher than that of control group （P < 0.05）. After treatment， the LVEDD， LVSDD in observation group were significantly lower than those of control group （P < 0.05）， the LVEF in observation group was significantly higher than that of control group （P < 0.05）. After treatment， the grading of heart function and BNP level in observation group were significantly lower than that of control group （P < 0.05）. The distance of 6-minute walk in observation group was significantly higher than that of control group （P < 0.05）. After treatment， the hs-CRP， TNF -α and IL-6 level in observation group was significantly lower than those of control group （P < 0.05）. Conclusion Rosuvastatin combined with coenzyme Q10 can significantly decline the serum inflammatory index and serum brain natriuretic peptide level， and they also can effectively improve the heart function of patients and can be applied in clinical application.

[Key words] Coenzyme Q10； Chronic heart failure； Serum inflammatory index； Serum brain natriuretic peptide； Cardiac function

慢性心力衰竭又被称作充血性心力衰竭，是多种心脏疾病终末期的一种临床综合征，以患者心脏功能减退为病理基础，继而引起机体全身各脏器组织得不到充足的血氧而产生临床综合征[1-2]。该病以老年患者多发，近年来随着我国老龄化加快，慢性心衰发生率逐年增加，流行病学调查表明60岁以上人群心衰发病率可高达10%[3]。流行病学调查表明我国成人慢性心力衰竭的发生率约在0.9%，严重威胁人民的生活质量和健康，甚至危及生命[4]。随着近年来对慢性心衰研究的不断深入，尽管取得了显著进展，但其发病率和死亡率仍然居高不下。研究表明他汀类药物能够显著改善慢性心衰患者心功能及临床症状，同时有助于纠正神经内分泌失调，而辅酶Q10是人体内唯一的辅酶Q类物质，具有抗氧化、清除自由基、抗肿瘤以及提高人体免疫、防老抗衰等广泛的生理功能，更为重要的是其能保护心血管功能[5-7]。……