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目的:研究阿托伐他汀对扩张型心肌病(DCM)患者血清肌钙蛋白I(cTnI)水平及预后的影响。方法:对72例DCM住院患者随机分成2组:他汀组及非他汀组(各36例),治疗前两组在性别、年龄、病程、NYHA心功能分级、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心律失常等方面无显著差异,两组均常规抗心力衰竭等治疗,而他汀组加用阿托伐他汀(立普妥)10 mg/d,分别随访1年,观察治疗前、治疗3个月后两组的cTnI水平变化情况,评估随访1年内主要不良心血管事件(心血管死亡、心脏骤停复苏及卒中)风险及心力衰竭再住院率。结果:他汀组治疗3个月后cTnI水平较非他汀组有所下降,但差异无统计学意义;随访期间非他汀组主要心血管不良事件发生16例次(48%),他汀组14例次(42%);非他汀组因心衰再住院16例次(48%),他汀组11例次(33%),P>0.05。结论:低剂量阿托伐他汀治疗对DCM患者的cTnI水平及预后无明显影响,对心衰住院率亦无明显降低作用。
Objective: To investigate the effect of atorvastatin on serum cTnI level and prognosis in patients with dilated cardiomyopathy (DCM). Methods: A total of 72 DCM inpatients were randomly divided into two groups: statin group and non-statin group (36 cases each). Before treatment, the gender, age, course of disease, NYHA functional class, left ventricular ejection fraction Left ventricular end-diastolic dimension (LVEDD), arrhythmia and other aspects were not significantly different, both conventional anti-heart failure treatment, while the statin group with atorvastatin (Lipitor) 10 mg / d, were followed up for 1 year . The changes of cTnI level in both groups before treatment and 3 months after treatment were observed. The risk of major adverse cardiovascular events (cardiovascular death, cardiac arrest and resuscitation and stroke) and rehospitalization rate of heart failure within one year of follow-up were evaluated. Results: The level of cTnI in statin group was lower than that in non-statin group after 3 months of treatment, but the difference was not statistically significant. During the follow-up period, 16 cases (48%) of major cardiovascular adverse events occurred in non-statin group and 14 cases (42%). In non-statin group, 16 cases were rehospitalized for heart failure (48%) and 11 cases (33%) in statin group, P> 0.05. Conclusion: Low-dose atorvastatin has no significant effect on cTnI level and prognosis in patients with DCM, nor does it significantly reduce the hospitalization rate of heart failure.