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| Effect of different doses of Atorvastatin combined with Metoprolol in the treatment of acute congestive heart failure complicated with renal insufficiency |
| LI Jing1 LYU Guofen2 LIU Junfa1▲ |
1.NO.2 Department of Cardiology, the Second Hospital of Handan City, Hebei Province, Handan 056001, China;
2.Department of Cardiology, Gucheng County Hospital, Hebei Province, Gucheng 053800, China |
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Abstract Objective To study the effect of different doses of Atorvastatin combined with Metoprolol in the treatment of acute congestive heart failure (CHF) complicated with renal insufficiency. Methods A total of 120 patients with acute CHF combined with renal insufficiency from April 2017 to April 2018 admitted to the Second Hospital of Handan City were selected as the research subjects and they were divided into observation group and control group by method of random sampling, with 60 cases in each group. The observation group was given Metoprolol and high-dose Atorvastatin (40 mg/d), and the control group was given Metoprolol and low-dose Atorvastatin (20 mg/d). After four weeks, the treatment effect of the two groups was compared, the cardiac function, renal function and levels of inflammatory factors were recorded before and after treatment in the two groups, and the incidence of adverse reactions during the treatment was recorded. Results There was no significant difference in the total effective rate between the two groups (P ＞ 0.05). The effect of the observation group was significantly better than that of the control group, the difference was statistically significant (P ＜ 0.05). After treatment, the left ventricular ejection fraction (LVEF) and the distance of 6 min walking test (6MWT) in the observation group were significantly higher than those before treatment and than those of the control group after treatment. After treatment, the left ventricular end diastolic diameter (LVEDD) of the observation group was significantly lower than that before treatment and that of the control group, and the difference was statistically significant (P ＜ 0.05). After treatment, the glomerular filtration rate (GFR) of the observation group was significantly higher than that before treatment and that of the control group. After treatment, the blood urea nitrogen (BUN) and the serum creatinine (Scr) of the observation group were significantly lower those before treatment and those of the control group, the differences were statistically significant (P ＜ 0.05). After treatment, the levels of hs-CRP, IL-6 and TNF-α in the observation group were significantly lower than those before treatment and those of the control group, the differences were statistically significant (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion High dose Atorvastatin combined with Metoprolol is superior to small dose in the treatment of acute CHF patients complicated with renal insufficiency, and the safety is high.
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