普伐他汀对类风湿关节炎患者血管内皮功能和氧化应激的影响

Effects of Provastatin on the Vascular Endothelial Functions and Oxidative Stress in Patients with Rheumatoid Arthritis

目的观察普伐他汀对类风湿关节炎(RA)患者血管内皮功能和氧化应激的影响。方法40例活动性RA患者随机分为:慢作用药物组20例;慢作用药物+普伐他汀治疗组20例;另设健康对照组20例。分别于治疗前和治疗8周后检测血清氧化应激指标的变化,用高分辨率超声仪检测肱动脉内皮依赖性和内皮非依赖性舒张功能的变化。结果与对照组比较,慢作用药物组患者血清丙二醛(MDA)、氧化低密度脂蛋白(oxLDL)及oxLDL与低密度脂蛋白(LDL)比值(oxLDL/LDL)明显升高,血管内皮舒张功能明显受损,且治疗前后差异无统计学意义。加用普伐他汀治疗后,血清MDA、oxLDL及oxLDL/LDL比值明显降低,血管内皮依赖性舒张功能明显改善。结论普伐他汀能有效改善类风湿关节炎患者的血管内皮功能,这种有益作用可能部分与其抗氧化应激作用有关。

Objective To study the effect of provastatin on endothelial functions and oxidative stress in patients with active rheumatoid arthritis（RA）.Methods A total of 40 patients with active RA were randomly divided into：disease modifying antirheumatoid drugs（DMARD）group,and DMARD plus provastatin group.Twenty healthy subjects were chosen as controls.Before and 8 weeks after treatment,MDA,oxLDL and oxLDL/LDL ratio were measured,endothelium-dependent and independent vasodilation of the brachial artery was assessed by the brachial ultrasound examination.Results As compared with healthy control group,serum MDA,oxLDL and oxLDL/LDL ratio were significantly increased,and endothelial function was obviously impaired in DMARD group.In DMARD plus provastatin group,serum MDA,oxLDL and oxLDL/LDL ratio were significantly reduced,and endothelium-dependent diastole function of brachial artery was improved significantly 8 weeks after treatment as compared with those before treatment.Conclusion Provastatin can improve endothelial function in patients with active RA,which may be partly attributed to reducing oxidative stress.