【摘要】 目的探讨几丁质酶-3样蛋白-1(YKL-40)在射血分数保留心力衰竭(HFPEF)患者诊断和评估病情严重程度中的临床价值及阿托伐他汀治疗HFPEF的有效性。方法选择70例HFPEF患者及35名健康体检者,均于入组时测定血脂及YKL-40水平,并进行6 min步行试验(6MWT)。将70例HFPEF患者随机分为阿托伐他汀组35例(在基础治疗上予阿托伐他汀20 mg/d)、对照治疗组35例(仅予基础治疗),并于治疗12个月后再次检测2组患者的血清YKL-40、血脂水平及进行6MWT。结果治疗前,阿托伐他汀组及对照治疗组患者YKL-40水平均明显高于健康对照组(P<0.05),且YKL-40水平与6MWT呈负相关(rs=-0.999,P<0.05)。治疗12个月时阿托伐他汀组YKL-40水平比对照治疗组下降更为明显,且6MWT改善更明显(P均<0.05)。结论阿托伐他汀能够进一步降低HFPEF患者血清YKL-40水平及改善心功能,YKL-40在评价心功能方面有一定的临床价值更多还原

【Abstract】 Objective To evaluate the influence of atorvastatin on serum chitinase-3-like protein-1(YKL-40) and cardiac function in patients with heart failure with preserved ejection fraction,and investigate the effect of YKL-40 in the diagnosis of HFPEF. Methods Serum YKL-40,serum lipid and 6-minute walk test(6MWT) were measured at baseline in both healthy control group(n = 35) and patients with HFPEF(n = 70). 70 patients with HFPEF were randomly assigned to control group who received routine therapy,and atorvastatin treatment group who received routine therapy and additional atorvastatin(20 mg/d). Serum YKL-40,lipid profiles and 6MWT were measured after 12-month treatment. Results The levels of YKL-40 were significantly higher in patients with HFPEF than healthy control group(P < 0. 05),the level of serum YKL-40 was strong negatively related with 6MWT(rs=- 0. 999,P < 0. 05). After 12 months treatment,the YKL-40 level in atorvastatin group is significantly reduced than control group(P < 0. 05),and 6 MWT also showed significant better than control group(P < 0. 05). Conclusion Atorvastatin can improve cardiac function and reduce YKL-40 level in patients with HEPEF. YKL-40 could be a prognostic biomarker in patients with HFPEF.更多还原