2019 年第 4 期 第 14 卷

阿托伐他汀对射血分数保留型慢性心力衰竭患者心室重构及血清几丁质酶3样蛋白1和基质金属蛋白酶9水平的影响

Effect of atorvastatin on ventricular remodeling and serum levels of chitinase-3-like protein-1 and matrix metalloproteinase-9 in patients with chronic heart failure with preserved ejection fraction

作者：郑学鸥刘慧峰华先平黄南清

英文作者：

单位：528415广东省中山市，南方医科大学附属小榄医院心血管内科

英文单位：

关键词：慢性心力衰竭；阿托伐他汀；射血分数保留；心室重构；几丁质酶3样蛋白1；基质金属蛋白酶9

英文关键词：

• 摘要：

• 【摘要】目的    探讨在常规治疗基础上联合阿托伐他汀治疗对射血分数保留型慢性心力衰竭患者心室重构指标及血清几丁质酶3样蛋白1（CHI3L1）和基质金属蛋白酶9（MMP-9）水平的影响。方法    选取南方医科大学附属小榄医院2017年1月至2018年5月收治的射血分数保留型慢性心力衰竭患者180例，应用随机数字表法分为观察组与对照组，各90例。对照组患者接受常规心力衰竭治疗，观察组在对照组治疗基础上联合阿托伐他汀钙片治疗。比较2组患者治疗前后心室重构相关指标以及血清CHI3L1和MMP-9水平的变化。结果    治疗前，2组患者心室重构相关指标以及血清CHI3L1和MMP-9水平比较差异均无统计学意义（均P＞0.05）。治疗后,2组患者的舒张早期血流峰速度减速时间、舒张早期二尖瓣血流速度和舒张早期二尖瓣环运动速度的比值、左心房容积指数和左心房质量指数水平以及血清CHI3L1和MMP-9水平均较治疗前降低、且观察组低于对照组［（202±43）ms比（252±56）ms，（8±3）比（11±4）,（30±6）ml/m2比（36±7）ml/m2，（126±8）g/m2比（146±9）g/m2，（226±102）μg/L比（290±116）μg/L，（62±5）μg/L比（105±8）μg/L］，舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度的比值均高于治疗前、且观察组高于对照组［（1.14±0.22）比（0.95±0.19）］，差异均有统计学意义（均P＜0.05）。结论    在射血分数保留型慢性心力衰竭患者的临床治疗中，在常规治疗基础上联合阿托伐他汀治疗，能够减轻患者的心室重构，降低患者血清CHI3L1和MMP-9水平，促进患者心脏功能的恢复。

• 【Abstract】Objective    To explore the effect of atorvastatin on ventricular remodeling and serum levels of chitinase-3-like protein-1(CHI3L1) and matrix metalloproteinase-9(MMP-9) in patients with chronic heart failure with preserved ejection fraction. Methods    Totally 180 patients with chronic heart failure with preserved ejection fraction admitted to Xiaolan Hospital Affiliated to Southern Medical University from January 2017 to May 2018 were randomly divided into observation group and control group, with 90 cases in each group. The control group was treated with routine therapy. The observation group was treated with atorvastatin on the basis of routine therapy. Ventricular remodeling indexes, levels of serum CHI3L1 and MMP-9 were analyzed. Results    There was no significant difference of ventricular remodeling indexes, serum CHI3L1 and MMP-9 levels between groups before treatment(P>0.05). After treatment, early diastolic peak velocity deceleration time, early diastolic mitral flow velocity to early diastolic mitral annulus velocity ratio, left atrial volume index, left atrial mass index, CHI3L1 and MMP-9 levels significantly decreased and they were significantly lower in observation group than those in control group［（202±43）ms vs （252±56）ms， （8±3） vs （11±4）, （30±6）ml/m2 vs（36±7）ml/m2， （126±8）g/m2 vs （146±9）g/m2， （226±102）μg/L vs （290±116）μg/L， （62±5）μg/L vs （105±8）μg/L］; early diastolic mitral flow velocity to late diastolic mitral flow velocity ratio significantly increased and the value in observation group was significantly higher than that in control group［（1.14±0.22） vs （0.95±0.19）］（all P＜0.05）. Conclusion    In the clinical treatment of chronic heart failure with preserved ejection fraction, the use of atorvastatin on the basis of routine treatment can significantly alleviate ventricular remodeling, reduce serum CHI3L1 and MMP-9 and promote cardiac function recovery.