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目的:探讨辛伐他汀联合曲美他嗪对慢性心力衰竭(CHF)患者心肌重塑指标及细胞因子表达水平的影响。方法:将126例CHF患者随机纳入A组(予常规治疗加辛伐他汀治疗)及B组(予常规治疗加辛伐他汀、曲美他嗪联合治疗);比较治疗后两组患者在心肌重塑指标及C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、外周血基质金属蛋白酶9(MMP-9)、脑钠肽(BNP)表达水平上的差异,并对两组6 min步行距离、心功能分级及治疗总有效率进行比较。结果:治疗后B组左室收缩末期内径(LVSD)、左室舒张末期内径(LVDD)、左心室射血分数(LVEF)均高于A组,CRP、TNF-α、IL-6、MMP-9、BNP表达水平下降程度均较A组明显,6 min步行距离、心功能Ⅰ~Ⅱ级比例及治疗总有效率均优于A组,以上差异均具有统计学意义(P<0.05或P<0.01)。结论:辛伐他汀联合曲美他嗪可改善CHF患者心功能,减少炎症细胞因子表达,缓解心肌纤维化,提高治疗效果。
Objective: To investigate the effects of simvastatin combined with trimetazidine on myocardial remodeling and cytokine expression in patients with chronic heart failure (CHF). Methods: One hundred and sixty-six patients with CHF were randomly divided into group A (conventional treatment plus simvastatin) and group B (conventional treatment plus simvastatin and trimetazidine combined treatment). After treatment, The expression of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and the levels of MMP-9 and BNP The differences of walking distance, heart function grading and total effective rate of 6 minutes were compared between the two groups. Results: After treatment, LVSD, LVDD and LVEF in group B were significantly higher than those in group A, CRP, TNF-α, IL-6 and MMP- 9, BNP expression levels were significantly lower than that of group A, 6 min walking distance, Ⅰ ~ Ⅱ level of cardiac function and total effective rate were better than group A, the above differences were statistically significant (P <0.05 or P < 0.01). Conclusion: Simvastatin combined with trimetazidine can improve cardiac function, reduce the expression of inflammatory cytokines, relieve myocardial fibrosis and improve the therapeutic effect in CHF patients.