目的 探討普伐他汀對(duì)心衰伴急性冠脈綜合征患者臨床療效及預(yù)后的影響。方法 選擇2014年1月—2017年3月在西安市第五醫(yī)院診治的心衰伴急性冠狀動(dòng)脈綜合征（ACS）患者119例，根據(jù)治療方法的不同分為觀察組60例與對(duì)照組59例。對(duì)照組在基礎(chǔ)治療的基礎(chǔ)上給予阿托伐他汀治療，觀察組在基礎(chǔ)治療的基礎(chǔ)上給予普伐他汀治療，都治療觀察1個(gè)月。比較兩組治療前后血脂、血管內(nèi)皮相關(guān)指標(biāo)的變化情況，比較兩組臨床療效及心血管不良事件的發(fā)生情況。結(jié)果 治療后兩組三酰甘油（TG）、總膽固醇（TC）與低密度脂蛋白膽固醇（LDL-C）值低于治療前，而高密度脂蛋白膽固醇（HDL-C）值高于治療前，對(duì)比差異都有統(tǒng)計(jì)學(xué)意義（P<0.05），組間對(duì)比差異無(wú)統(tǒng)計(jì)學(xué)意義。觀察組與對(duì)照組治療后的氧化低密度脂蛋白（OX-LDL）水平顯著低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組也顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后兩組的反應(yīng)性充血內(nèi)徑變化率顯著高于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組也高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組治療前后肱動(dòng)脈基礎(chǔ)內(nèi)徑與反應(yīng)性充血時(shí)內(nèi)徑對(duì)比差異無(wú)統(tǒng)計(jì)學(xué)意義。觀察組治療的總有效率（95.00%）顯著高于對(duì)照組（89.83%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。所有患者治療后隨訪1年，觀察組的心源性死亡、再發(fā)心肌梗死、靶病變血管重建等MACE發(fā)生率為5.0%，對(duì)照組為18.6%，觀察組顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 普伐他汀在心衰伴ACS患者中的應(yīng)用可起到調(diào)節(jié)血脂與抑制OX-LDL的雙重作用，從而改善血管內(nèi)皮功能，提高臨床療效，改善患者的遠(yuǎn)期預(yù)后。

Objective To investigate the effects of pravastatin on clinical efficacy and prognosis of patients with heart failure combined with acute coronary syndrome(ACS).Methods From January 2014 to March 2017, 119 cases of heart failure combined with ACS patients were selected and were divided into the 60 cases in the observation group and 59 cases in the control group accorded to the different treatment methods. The control group was treated with atorvastatin, the observation group was treated with pravastatin on the basis of the control group, and the two groups were treated for 1 months. The changes of blood lipids and vascular endothelium related parameters before and after treatment were compared between the two groups, and the clinical efficacy and occurrence of adverse cardiovascular events in the two groups was compared. Results After treatment, the values of TG, TC and LDL-C in the two groups were lower than those before the treatment, while the HDL-C values were significantly higher than those before the treatment (P<0.05), and there were no significant difference in the comparison between the groups. The content of OXLDL in the observation group and the control group after treatment were significantly lower than that before treatment (P<0.05), and the observation group were also significantly lower than that in the control group (P<0.05). After treatment, the change rate of reactive hyperemia in the two groups were significantly higher than that before treatment (P<0.05), and the observation group were also higher than that of the control group (P<0.05), there were no significant difference compared between the two groups of brachial artery base diameter and reactive hyperemia before and after treatment. The total effective rate (95.00%) in the observation group was significantly higher than that in the control group (89.83%) (P<0.05). All patients were followed up for 1 years, the incidence of MACE in the observation group were 5%, so that were 18.6% in the control group, and the observation group were lower than the control group (P<0.05).Conclusions The application of pravastatin in patients with heart failure combined ACS can play a dual role in regulating blood lipids and inhibiting OX-LDL, thus improve vascular endothelial function, clinical efficacy and the long-term prognosis of patients.