Objective: To study therapeutic effects of trimetazidine (TMZ) combined atorvastatin in patients with chronic heart failure (CHF) and its mechanism. Methods: A total of 109 CHF patients were randomly divided into routine treatment group (n = 56) and TMZ + atorvastatin intervention group (combined intervention group, n = 53). Changes of levels of high sensitive C reactive protein (hsCRP), matrix metalloproteinase (MMP) - 9, left ventricular ejection fraction (LVEF) and left ventricular end- diastolic dimension (LVEDd) were measured and compared between two groups before treatment, two weeks and six months after treatment. Results; Compared with routine treatment group, there were significant decrease in levels of hsCRP [after six months: (4. 47 ± 2. 37) mg/L vs. (3.11 ±2. 04) mg/L] and MMP-9 [after six months: (558. 69 ±210.14) ng/L vs. (442. 77 ± 183. 25) ng/L, P <0. 05 both], and significant increase in LVEF [after six months: (51. 4 ± 4. 4) % vs. (57. 3 ± 5.1) %, P<0. 05] in combined intervention group on two weeks and six months after treatment; the LVEDd was not significant different between two groups after treatment (F>0. 05), but LVEDd of combined intervention group was significantly lower than that of before treatment [ (54. 5 ± 6.1) mm vs. (59. 7 ± 6. 3) mm, P<0. 05]. Conclusion: Trimetazidine combined atorvastatin therapy can decrease levels of high sensitive C reactive protein, matrix metalloproteinase - 9 and improve ventricular remodeling and cardiac function in patients with chronic heart failure.%目的:研究曲美他嗪联合阿托伐他汀对慢性心力衰竭(CHF)患者的疗效及其机制.方法:109例CHF患者被随机分为常规治疗组(56例)和曲美他嗪联合阿托伐他汀干预组(联合干预组,53例),分别检测两组治疗前、治疗2周及6月后的超敏C反应蛋白(hsCRP)、基质金属蛋白酶(MMP)-9及左室射血分数(LVEF)、左室舒张末内径(LVEDd)的变化.结果:与常规治疗组相比,联合干预组治疗后2周及6月hsCRP[6个月后:(4.47±2.37) mg/L比(3.11±2.04) mg/L]、MMP-9[6个月后:(558.69±210.14) ng/L比(442.77±183.25)ng/L]水平显著降低(P均＜0.05),LVEF值显著提高[6个月后:(51.4±4.4)％比(57.3±5.1)％,P＜0.05],LVEDd无显著差异(P＞0.05)；但联合干预组LVEDd较治疗前明显降低[(54.5±6.1)mm比(59.7±6.3) mm,P＜0.05].结论:曲美他嗪联合阿托伐他汀治疗可降低慢性心力衰竭患者超敏C反应蛋白及基质金属蛋白酶-9水平,改善心室重构及心功能.
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