普伐他汀治疗肾移植术后血脂异常的临床研究

Clinical study of pravastatin in treatment of dyslipidemia after renal transplantation

目的探讨他汀类药物对肾移植术后血脂异常患者的疗效。方法21例肾移植术后高胆固醇血症患者(血浆总胆固醇水平>6.2mmol/L),每日口服普伐他汀10mg,每晚1次,疗程8周。治疗前后测定本组及30例健康人(对照组)血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、血浆内皮素(ET)、一氧化氮(NO)的变化。并采用高分辨血管外超声技术测定所有个体肱动脉血流介导的舒张功能及硝酸甘油介导的舒张功能。结果血浆ET在肾移植组显著高于对照组,而NO显著低于对照组;降脂治疗8周后,ET明显下降(P<0.01),NO明显升高(P<0.01),血TC、LDL-C、TG水平明显降低(P<0.01,P<0.05),HDL-C亦升高,但无统计学意义。治疗组肱动脉血流介导的舒张低于对照组,治疗后较治疗前明显好转。结论肾移植患者应用普伐他汀调脂治疗,可显著改善血管内皮细胞功能。

Objective To investigate curative effect of pravastatin in treament of dyslipidemia after renal transplantation. Methods Twenty one dyslipidemia patients （serum total cholesterol 〉 6.2 retool/L） who underwent renal transplantation accepted pravastatin therapy 10 nag once evening for 8 weeks. Total cholesterol （TC）, low- density lipoprotein - cholesterol （ LDL - C）, high - density lipoprotein- cholesterol （FIDL - C）, triglyceride（TG）, endothelin（ET） and nitrous oxide（NO） were measured before and after pravastatin therapy. The endothelium - dependent relaxing function was measured before and post pravastatin therapy by high - resolution ultrasound. Thirty people with normal blood cholesterol accepted same examination as control. Results The level of ET in renal transplantation group was significantly higher than that of control group,and the level of NO in renal transplantation group was significantly lower than that of control group. After 8 week＇s therapy,the level of NO rose significantly, and the level of ET,TC, LDL- C, TG decreased significantly. The level of HDL- C increased but there was no significant difference between two groups, Flow - mediated vasodilations were improved after pravastatin therapy,while the level in transplantation group was lower than that of control group. Conclusion Pravastatin is effective in treatment of dyslipidemia after renal transplantation, which can improve the endothelittm - dependent vasodilation.