阿托伐他汀联合叶酸治疗老年射血分数保留的心力衰竭合并高同型半胱氨酸血症的疗效分析
Efficacy analysis of atorvastatin combined with folic acid in the treatment of elderly heart failure with preserved ejection fraction and hyperhomocysteinemia
付涛 1庞静 1李昌1
作者信息
- 1. 江汉大学附属湖北省第三人民医院心血管内科 湖北 武汉 430033
- 折叠
摘要
目的:分析阿托伐他汀联合叶酸治疗老年射血分数保留心力衰竭(HFpEF)合并高同型半胱氨酸血症(HHcy)的临床效果.方法:选取2020年1月至2022年1月湖北省第三人民医院心血管内科收治的老年HFpEF合并HHcy患者172例,随机分为对照组(43例)、阿托伐他汀组(43例)、叶酸组(43例)和联合组(43例).分别检测治疗前和治疗10周后患者血浆同型半胱氨酸(Hcy)、N末端B型钠尿肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-a水平,心脏彩超检测患者左心室射血分数(LVEF)、舒张早期血流峰速度减速时间(DT)、二尖瓣舒张期E峰流速/二尖瓣舒张期A峰流速(E/A)比值,测定6 min步行距离.结果:治疗后,各组患者的血浆Hcy、NT-proBNP、hs-CRP、TNF-a水平下降,叶酸组、阿托伐他汀组、联合组治疗后观察到更显著的下降,以联合组各项指标下降最为显著(P＜0.05).治疗后各组患者6 min步行距离增加,心脏彩超显示各组患者E/A比值升高,DT下降,联合组效果更为显著(P＜0.05).叶酸组、阿托伐他汀组及联合组治疗有效率均高于对照组,且联合组的差异最为显著(P＜0.05).结论:阿托伐他汀联合叶酸用于治疗老年HFpEF合并HHcy患者,能显著改善心功能,抑制心室重构,减轻炎性反应,抑制病情进展,具有积极的临床意义.
Abstract
Objective:To assess the clinical effect of atorvastatin combined with folic acid in the treatment of elderly patients with heart failure with preserved ejection fraction(HFpEF)and hyperhomocysteinemia(HHcy).Methods:From January 2020 to January 2022,172 elderly patients with HFpEF combined with HHcy in admission were selected in the Department of Cardiology,the Third People's Hospital of Hubei Province Affiliated to Jianghan University.All the patients were ran-domly divided into four groups,including the control group(43 cases),atorvastatin group(43 cases),folic acid group(43 cases),and combined group(43 cases)according to their treatment.The levels of homocysteine(Hey),N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity C-reac-tive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were detected before treatment and ten weeks after treatment.The left ventricular ejection fraction(LVEF),deceleration time of peak flow velocity in early diastole(DT),and left ventricular early diastolic peak flow velocity/atrial systolic peak flow velocity(E/A)ratio were measured by echocardiography.The six-minute walk distance(6MWD)was determined and recorded.Results:After treatment,the serum levels of Hey,NT-proB-NP,hs-CRP,and TNF-α were decreased in all groups,and the combined group had the most signifi-cant decrease in all the indicators(P＜0.05).The 6MWD increased in all groups of patients after treatment,and echocardiography showed an increase in the E/A ratio and a decrease in DT in all groups,with the combined group demonstrating the most significant effects(P＜0.05).The treat-ment effective rates in the folic acid group,atorvastatin group,and the combined group were all high-er than those in the control group,and the difference in the combined group was the most significant(P＜0.05).Conclusion:Atorvastatin combined with folic acid in the treatment of elderly patients with HFpEF combined with HHcy can significantly improve cardiac function,inhibit ventricular remodel-ing,reduce inflammation,and inhibit disease progression.
关键词
射血分数保留/心力衰竭/高同型半胱氨酸血症/叶酸/阿托伐他汀Key words
Preserved Ejection Fraction/Heart Failure/Hyperhomocysteinemia/Folic Acid/Atorvastatin引用本文复制引用
基金项目
湖北省卫生健康委员会资助项目(WJ2021F137)
出版年
2024
NETL
NSTL
万方数据