辛伐他汀对COPD急性加重期患者诱导痰血管内皮生长因子水平和肺功能的影响

Simvastatin Improves Pulmonary Function and Vascular Endothelial Growth Factor Level in Induced Sputum of Patients with COPD Exacerbation

目的探讨辛伐他汀对COPD急性加重期(AECOPD)患者诱导痰血管内皮生长因子(VEGF)水平和肺功能的影响。方法选择2007年5月至2008年11月住院的58例AECOPD患者,随机分常规组(30例)和他汀组(28例)。常规组按照诊疗常规予以AECOPD常规治疗,他汀组在常规治疗基础上加用辛伐他汀治疗。两组均于入院第1d和治疗1周后行肺功能检查,并收集诱导痰,采用ELIAS方法测定血清和诱导痰上清VEGF的含量。结果治疗前两组肺功能(FEV1%pred和FEV1/FVC)、诱导痰VEGF水平无显著差异(P>0.05)。常规组治疗1周后与治疗前比各项指标无明显变化(P>0.05)。他汀组治疗1周后FEV1%pred和FEV1/FVC均较治疗前显著升高(P均<0.01),且显著高于常规组(P均<0.01);诱导痰VEGF的水平较治疗前及常规组显著升高(P均<0.05),但血清VEGF的水平两组及两组治疗前后无显著差异(P均<0.05)。治疗1周后诱导痰VEGF水平与FEV1%pred和FEV1/FVC呈正相关(r=0.430,P<0.05;r=0.388,P<0.05)。结论辛伐他汀可改善AECOPD患者肺功能,并提高AECOPD患者诱导痰VEGF的水平。肺功能的改善可能与肺内VEGF水平的恢复有关。

Objective To investigate the effects of simvastatin on pulmonary function and vascular endothelial growth factor （VEGF） levels in induced sputum of patients with COPD exacerbation（AECOPD）.Methods Thirty-eight patients with AECOPD were divided into two groups randomly,ie.a routine medical treatment（RT） group（n=30） and a routine ＋ statin medical treatment（RST） group（n=28）.The VEGF levels in serum and induced sputum were detected by ELISA on the first day and after a week treatment in hospital,respectively.Meanwhile,the pulmonary function measurements were performed.Results There were no significant differences in the pulmonary function （FEV1%pred and FEV1/FVC） and VEGF levels in induced sputum between the two groups before treatment（P0.05）.The RT group showed no significant changes in any parameters before and after a week treatment（P0.05）.FEV1%pread,FEV1/FVC and VEGF levels in induced sputum in the RST group after a week treatment significantly increased compared with those before treatment and the RT group（P0.01,P0.01,P0.05）.But There were no significant differences in serum VEGF levels between the two groups before and after a week treatment.The VEGF levels in induced sputum were positively correlated to FEV1%pread and FEV1/FVC after a week treatment（r=0.430,P0.05;r=0.388,P0.05）.Conclusions Simvastatin may reduce the decline in pulmonary function and decrease the levels of VEGF in induced sputum of patients with AECOPD.Improvement in pulmonary function may be related to down-expression of lung VEGF.