卡维地洛联合阿托伐他汀对老年CHF患者心功能及外周血血浆IL-18、IL-18BPa、IL-37表达水平的影响

摘要

Objective:To investigate the effects of carvedilol combined with atorvastatin on cardiac function and plasma interleukin (IL)-18,IL-18 binding protein a (IL-18BPa) and IL-37 levels in senior patients with chronic heart failure (CHF).Methods:162 patients with CHF from February 2012 to November 2015 treated in our hospital were selected and randomly divided into a control group (n =81) and an observation group (n =81).The patients in the control group received carvedilol,while those in the observation groupwere treated as the control group with addition of atorvastatin.The clinical curative effect,cardiac function,and IL-18,IL-18BPa and IL-37 levels in plasma as well as adverse reactions were compared between the two groups.Results:The response rate in the observation group was significant higher than that in the control group (x2=8.30,P =0.004).After treatment,the left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in the observation group were superior to those in the control group (P ＜0.05).The IL-18,IL-18BPa and IL-37 levels in plasma in the observation group were lower than those in the control group (P ＜0.05).There were no significant differences in adverse reactions between the two groups (x2 =0.33,P =0.563).Conclusion:Carvedilol combined with atorvastatin has a synergistic effect on CHF treatment.This combination could reduce the levels of IL-18,IL-18BPa and IL-37 in plasma,improve cardiac function,and elevate clinical curative effect.%目的:探讨卡维地洛联合阿托伐他汀对老年慢性心力衰竭(CHF)患者心功能及外周血血浆白介素(IL) 18、IL-18结合蛋白a(IL-18BPa)、IL-37表达水平的影响.方法:选择2012年2月至2015年11月在山东省东营鸿港医院治疗的老年CHF患者162例,根据随机数字表法分为对照组和观察组,每组81例.两组均给予常规治疗,对照组在此基础上口服卡维地洛治疗,观察组在对照组基础上口服阿托伐他汀治疗.比较两组患者的临床疗效、心功能指标、外周血血浆IL-18、IL-18BPa、IL-37表达水平及不良反应发生情况.结果:观察组的治疗总有效率显著高于对照组(x2=8.30,P=0.004),观察组治疗后左室射血分数(LVEF)、左心室舒张末内径(LVEDD)和左心室收缩末内径(LVESD)均显著优于对照组,外周血血浆IL-18、IL-18BPa、IL-37表达水平均明显低于对照组,差异均具有统计学意义(均P＜0.05).两组患者不良反应发生率比较差异无统计学意义(x2=0.33,P=0.563).结论:卡维地洛联合阿联合托伐他汀应用于老年CHF的治疗具有协同作用,可同时下调老年CHF患者外周血血浆IL-18、IL-18BPa、IL-37表达水平,共同改善患者心功能,并提升临床疗效.