瑞舒伐他汀对慢性阻塞性肺病合并肺动脉高压患者的影响

Effect of rosuvastatin on chronic obstructive pulmonary disease patients combined with pulmonaryhypertension

目的评价瑞舒伐他汀对慢性阻塞性肺病（COPD）合并肺动脉高压（PH）患者一氧化氮（NO）、内皮素-1（ET-1）、肺动脉压力（PASP）、右心功能的影响及其安全性。方法将80例COPD合并PH患者分为他汀组（40例）和对照组（40例），两组均给予常规治疗，同时他汀组加用瑞舒伐他汀10mg／d，对照组不用任何调脂药。治疗前和治疗后6个月分别检测血清NO、ET-1浓度及肝肾功能、血肌酸磷酸激酶（CK）水平，测定PASP、Tei指数。结果治疗6个月后两组NO均升高，与治疗前比较差异均有统计学意义（P〈0．01），但他汀组升高更明显，组间比较差异有统计学意义（P〈0．05）。治疗6个月后两组ET-1、PASP、Tei指数均显著降低，与治疗前比较差异均有统计学意义（P〈0．01），但他汀组降低更明显，组间比较差异有统计学意义（P〈0．05）。两组治疗前后肝肾功能及CK水平比较差异无统计学意义（P〉0．05），不良反应少。结论瑞舒伐他汀可升高COPD合并PH患者血清NO浓度．降低ET-1浓度，降低PASP及Tei指数，改善右心功能，其安全性良好。

Objective To evaluate the Endothelin-1 （ ET-1 ）, obstructive pulmonary Eighty COPD patients pulmonary artery systolic disease patients （COPD） influence and safety of rosuvastatin on pressure （PASP） and right ventricular nitric oxide （ NO ）, function in chronic combined with puhnonary hypertension（PH）. Methods combined with PH were enrolled and divided into the statin group （ n = 40） and the control group （ n = 40）. All patients were given conventional therapy, while the statin group reeeived rosuvastatin 10 mg/d, the control group did not receive any lipid-lowering drugs. The plasma levels of NO and ET-1, echocardiography indicators of PASP and right ventricular Tei index, liver and kidney functions and creatine kinase（CK） were measured and compared before and after 6-month treatment. Results The level of NO was significantly higher after 6-month treatment than before treatment in the two groups （P 〈 0.01 ）, but the statin group increased even more significantly （P 〈 0.05 ）. The levels of ET-1, PASP and Tel index were significantly lower after 6-month treatment than before treatment in the two groups （P 〈 0.01 ）, but the statin group reduced even more significantly （P 〈 0.05 ）. Statistical differences of liver and kidney function and serum CK were not found in the two groups before and after treatment （P 〉 0.05）. The adverse reaction in the statin group was few. Conclusions Rosuvasta- tin can increase the level of NO, reduce the levels of ET-1, PASP and Tei index, make right ventricular function better in COPD patients combined with PH, and its security is good.