普伐他汀治疗肾移植术后血脂异常的临床研究

Clinical study of Pravastatin therapy 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疗效及安全性。方法21例肾移植术后高胆固醇血症患者(血浆总胆固醇TC水平>6.2mmol/L),患者每日口服普伐他汀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明显降低(P<0.01),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。没有病例发生横纹肌溶解。结论肾移植患者普伐他汀调脂治疗的同时,可显著改善血管内皮细胞功能。普伐他汀治疗肾移植后高脂血症安全有效。

[Objective] To investigate curative effect and safety of Pravastatin of dyslipidemia after renal transplantation. [Methods] 21 dyslipidemia patient （serum total cholesterol 〉 6.2 mmol/L） who underwent renal transplantation accepted Pravastatin therapy 10 mg qn tot 8 week. Mensurate total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, triglyceride （TG）, endothelin （ET） and ni- trous oxide（NO）change before and post Pravastatin therapy with high-reso-lution ultrasound, we also measured endothelium-dependent relaxing function before and post Pravastatin therapy, 30 people with normal blood cholesterol accept upwards examination at same time. [Results] In renal transplantation group, ET significantly higher than control group and NO significantly lower. After therapy, NO significantly rised. ET, TC, LDL-C significantly failed, HDL-C rised but had no significance. Flow-mediated vasodilations were greater after Pravastatin therapy than before, but smaller than control group. No patients have rhabdomyolysis. [Conclusion] Pravastatin can cure dyslipidemia after renal transplantation and improve impaired endothelium-dependent vasodilation. Treatment of pravastatin to dyslioidemia after renal transolantation is safe.