同型半胱氨酸及甲状腺功能在他汀致冠心病患者肝功能异常中的研究

To Study the Effect of Homocysteine and Hhyroid Functionin the Statin Induced Liver Dysfunction by Atorvastatin Ttreatment in Severes Corony Artery Disease Patients

目的:研究同型半胱氨酸及甲状腺功能与他汀致冠心病患者肝功能异常的相关性。方法:服用阿托伐他汀钙(20mg,1次/日)后1-3个月肝功能正常组(ALT和AST均正常者)300例;肝功能轻度异常组(ALT或/和AST升高3倍以下者)300例;肝功能重度异常组(ALT或/和AST升高3倍以上者)300例。在转氨酶重度升高组中选取停用他汀药观察组和加用CoQ10(20mg,3次/日)治疗组各100例,对比两组转氨酶下降情况。结果:PCI术后服用他汀类药物治疗1-3个月后出现肝功能异常的冠心病患者,同型半胱氨酸水平升高,甲状腺功能降低;肝功能的异常与年龄及饮酒有相关性。转氨酶重度升高患者中,加用CoQ10治疗组较仅停药组转氨酶显著下降。结论:阿托伐他汀钙引起的冠心病患者同型半胱氨酸水平升高及甲状腺功能下降与肝功能损伤有明显相关性。CoQ10可显著降低转氨酶水平。

Objective： To study the relationship between the level of homocysteine, thyroid function and liver dysfunction induced by atorvastatin treatment in severes corony artery disease patients. Methods： All selected patients have been treated with atorvastatin calcium （20mg, 1 times / day） for 1-3 months. Three hundred cases of normal liver function （ALT and AST were normal） were selected as control group.Three hundred cases of moderate liver dysfunction （ALT and / or AST was increased less than three-fold）.Three hundred cases of severe liver dysfunction （ALT and / or AST increased more than 3 times）. In the group of liver dysfunction, we selected 100 cases of drug withdrawal and 100 cases with CoQ10 （20mg, 3 times / day） treatmentrespectively. Results： In coronary heart disease patients with statin therapy after PCI for 1-3 months, elevated homocysteine level and reduced thyroid function was observedin liver dysfunction group compared with normal liver function group （P〈0.01）. Liver dysfunction is related to age and alcohol intake. In patients with severely elevated transaminase, we found that with additonal CoQ10 treatment,transminase is significantly decreased compared with no treatment group （P〈0.01）. Conclusion： Elevated aminotransferases in patients with atorvastatin calcium was associated with treatment increased homocysteine and hypothyroidism. Liver dysfunction was correlated with drinking and age. Transaminase level in patients with abnormal liver function was decreased significantly after CoQ 10 treatment（P〈0.01）.