陈乐鸿

[摘要]目的 比较不同剂量瑞舒伐他汀口服治疗冠心病心力衰竭患者的临床效果。方法 回顾性分析我院2014年5月～2015年8月收治的98例冠心病心力衰竭患者的临床资料，根据治疗方法的不同分为低剂量组和高剂量组，各49例。低剂量组每日口服10 mg瑞舒伐他汀，高剂量组每日口服20 mg瑞舒伐他汀。比较两组的治疗效果、左心室指数、血浆标志物、6 min步行距离以及不良反应情况。结果 两组的总有效率及不良反应发生率比较，差异无统计学意义（P>0.05）。高剂量组治疗后的LVEF、LVESD及LVEDD水平显著优于低剂量组，差异有统计学意义（P<0.05）。高剂量组治疗后的hs-CRP、NT-proBNP水平以及6 min步行距离均优于低剂量组，差异有统计学意义（P<0.05）。结论 高剂量瑞舒伐他汀对冠心病心力衰竭患者同样具有治疗效果，且症状改善程度更佳，左心室功能恢复更好，不良反应未明显增加，值得临床推广应用。

[关键词]冠心病；心力衰竭；瑞舒伐他汀；心功能

[中图分类号] R541.6 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0111-03

[Abstract]Objective To compare the clinical effect of different doses of Rosuvastatin in the treatment of coronary heart disease （CHD） complicated with heart failure.Methods The clinical data of 98 CHD patients complicated with heart failure from May 2014 to August 2015 in our hospital was retrospectively analyzed，all patients were randomly divided into the low dose group and the high dose group according to the different therapies，49 cases in each group.The low dose group was treated with 10 mg of Rosuvastatin each day，the high dose group was treated with 20 mg of Rosuvastatin each day.The treatment effect，left ventricular function index，plasma marker，6-minute walking distance and adverse reactions in the two groups were compared.Results There was no significant difference in the total effective rate and the incidence rate of adverse reactions between the two groups （P>0.05）.The level of LVEF，LVESD，LVEDD after treatment in the high dose group was better than that in the low dose group，with significant difference （P<0.05）.The level of hs-CRP，NT-proBNP and 6-minute walking distance after treatment in the high dose group was better than that in the low dose group，with significant difference （P<0.05）.Conclusion The high dose of Rosuvastatin has an obvious effect in CHD patients with heart failure，which can improve the clinical symptoms and promote the recovery of left ventricular function.In addition，the adverse reaction is not increased.It is worthy of clinical application and promotion.

[Key words]Coronary heart disease；Heart failure；Rosuvastatin；Cardiac function

冠心病是临床心内科常见疾病，主要是由于冠状动脉粥样硬化引起心血管堵塞或狭窄，造成心肌缺血缺氧，引起心肌坏死，最终导致的心脏病，主要发生于中老年群体，是一种慢性疾病。心力衰竭是冠心病患者发展到终末期时的主要症状，是冠心病患者死亡的主要原因[1]。有研究显示，冠心病患者诱发心力衰竭的主要因素是低密度脂蛋白水平升高[2]，因此如何调节血脂水平是防治冠心病患者发生心力衰竭的重要措施。目前，临床上常采用瑞舒伐他汀对冠心病心力衰竭患者进行治疗，瑞舒伐他汀具有明显调脂作用，能抑制炎症、稳定斑块，对心力衰竭具有明显疗效[3]，但瑞舒伐他汀的最佳有效剂量在临床上的研究较少，一般采用10 mg每日口服。加大治疗剂量是否能进一步促进疗效成为人们关注的重点。本……