【摘要】 目的探讨阿托伐他汀用于慢性肺源性心脏病(肺心病)的效果及可能机制。方法将68例慢性肺心病缓解期患者随机分为对照组35例和治疗组33例,选取同期进行体检的健康人30例作为正常组。对照组和治疗组均接受常规治疗,治疗组在此基础上口服阿托伐他汀20 mg/d,连续6个月。治疗组及对照组分别于治疗前及治疗后6个月、正常组于入组后次日检测下列指标:循环内皮祖细胞(EPCs)数量及迁移、黏附功能;肺功能、肺动脉压(PAP)及血浆高敏-C反应蛋白(hs-CRP)、IL-8水平。结果治疗组和对照组治疗前循环EPCs数量及迁移、黏附能力均无显著差异,但两组均显著低于正常组(P均<0.01);治疗后治疗组上述指标均显著升高,且显著高于对照组(P均<0.05);治疗前治疗组和对照组肺功能指标及PAP、hs-CRP、IL-8比较P均>0.05,但两组血浆hs-CRP、IL-8水平、PAP均显著高于正常组(P均<0.01),FVC、FEV1、FEV1/FVC等肺功能指标均显著低于正常组(P均<0.01);治疗后治疗组FEV1、FEV1/FVC等肺功能指标明显升高(P<0.05),PAP、hs-CRP、IL-8均较同组治疗前和对照组明显降低(P均<0.05);治疗组口服阿托伐他汀期间1例出现AST升高2.8倍,1例出现肌痛、肌酸激酶升高2.2倍,停药后均恢复正常。结论阿托伐他汀可改善慢性肺心脏病患者的肺功能、降低PAP,机制可能与增加循环EPCs数量、改善其功能及抑制肺血管炎性反应有关。更多还原

【Abstract】 Objective To explore the effect of atorvastatin on patients with hypoxia pulmonary hypertension and its mechanism.Methods Total of 68 patients with chronic pulmonary heart disease in stable period were randomly divided into control group(n=35) and treated group(n=33),and 30 healthy control were picked up from people taking physical examination at the same stage.Both of the two groups of patients were given routine treatment and the treated group were given atorvastatin(20 mg/d) supplement for 6 months.Changes in pulmonary function,ultrasound cardiogram,hs-CRP and IL-8,the number and functions of endothelial progenitor cells(EPCs) in the control group and treated group were observed before and after 6 months of treatment,and those indexes in healthy control group were observed on the next day after be elected.Results The number and migration,adhesion activity of circulating EPCs in the control group and treated group before treatment showed no significant difference,but were all significantly lower than those in the healthy control group(all P<0.01);The above indexes increased in the treated group after the treatment,and were significantly higher than those in the control group(all P<0.05);The pulmonary function indexes,pulmonary arterial pressure(PAP) and levels of hs-CRP,IL-8 in the control group and treated group before treatment showed no significant difference(all P>0.05),but were all significantly higher than those in the healthy control group(all P<0.01),the pulmonary function indexes of FVC,FEV1,FEV1/FVC were significantly lower than those in the healthy control group(all P<0.01);The pulmonary function indexes including FEV1 and FEV1/FVC were much better in the treated group after treatment(all P<0.05),while the PRP,hs-CRP and IL-8 decreased after 6 months(P<0.05);The AST of one patient increased 2.8 fold,myalgia and increased creatine kinase of 2.2 fold were found in another patient,the above clinical manifestation returned to更多还原