不同剂量阿托伐他汀对肺心病患者big-ET及hs-CRP及PAP水平的影响

Effects of different doses of atorvastatin on serum lipids,big-ET,hs-CRP and PAP in hyperlipidemia patients with chronic cor pulmonale

目的对肺心病并高脂血症患者应用不同剂量阿托伐他汀治疗,观察其调脂的同时对大内皮素(big-ET)及超敏C-反应蛋白(hs-CRP)的影响,及肺动脉压力(PAP)改变情况。方法将在我院就诊的肺心病高脂血症患者100例,随机分为2组,即A组(阿托伐他汀10mg,每晚1次)、B组(阿托伐他汀20mg,每晚1次)。2组之间匹配非处理因素,比较2组治疗24周后血脂水平,big-ET及Hs-CRP、PAP变化情况。结果 2组在治疗24周后血脂及内皮功能、肺动脉压力均有改善,血清hs-CRP水平均有降低(P<0.05),B组24周后big-ET水平及hs-CRP水平明显低于A组(P<0.05)。PAP改善B组较A组明显(P<0.05)。2组之间不良反应率间差异有统计学意义(P<0.01)。结论他汀类药物在调脂的同时具有非调脂依赖性心脏保护作用,可改善血管内皮功能、抑制慢性炎症反应,降低肺动脉压力、改善心功能,并随剂量的增加其作用增加。

Objective To investigate the safety and therapeutic effect of different doses of atorvastatin on lipid-lowering,endothelial function,high-sensitivity C-reactive protein （ hs-CRP） and pulmonary artery pressure （ PAP） in hyperlipidemia patients with chronic cor pulmonale. Methods 100 hyperlipidemia patients with chronic cor pulmonale were randomly divided into two groups. The patients in disorder lipidemia group were given atorvastatin 10mg qd or 20 mg qd for 24 weeks. The levels of TC,TG,LDL-C,HDL-C,big-ET and hs-CRP,PAP were determined in disorder lipidemia groups 24 hours after pretreatment or treatment. Results TC and LDL-C were decreased significantly（ P 〈0. 05） in both groups after 24 weeks,but the decrease in atorvastatin 20mg qd group was more obvious. Big-ET in atorvastatin 20mg qd group was reduced from （ 0. 69 ± 0. 26 ） pmol/L before treatment to （ 0. 43 ± 0. 07） pmol/L after 24-week treatment,which also was significantly lower than that of atorvastatin 10mg qd group（ 0. 51 ± 0. 08） pmol/L （ P〈 0. 05）. hs-CRP in atorvastatin 20mg qd group was decreased from（ 7. 1 ± 2. 1） mg/L before treatment to（ 3. 8 ± 0. 4） mg/L after 24-week treatment,which was significantly lower than that of atorvastatin 10mg qd group（ 4. 4 ± 0. 6） mg/L（ P 〈0. 05）. PAP in atorvastatin 20mg qd group was reduced from（ 54 ± 18） mmHg before treatment to（ 30 ± 7） mmHg after 24-week treatment,which was significantly lower than that of atorvastatin 10mg qd group（ 42 ± 8） mmHg（ P 〈0. 05）. Conclusion The atorvanstain can reduce obviously blood lipid,hs-CRP and PAP,and can improve endothelial function. The administration of atorvanstain 20mg qd is safe,which is effective in controlling blood lipid,decreasing hs-CRP,PAP and improving endothelial function.