辛伐他汀治疗慢性阻塞性肺疾病合并肺动脉高压疗效观察

Curative effect of simvastatin in the treatment of chronic obstructive pulmonary disease complicated with pulmonary arterial hypertension

目的观察辛伐他汀对慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)患者的治疗效果。方法选择COPD合并PAH患者80例,随机分为治疗组和对照组各40例。对照组予常规治疗,治疗组在常规治疗基础上口服辛伐他汀,治疗前和治疗3个月后观察第1秒用力呼气容积占预计值百分比(FEV1%)和用力肺活量(FVC)、肺动脉平均压(PAPm)、肺动脉收缩压(PAPs)、血清C-反应蛋白(CRP)和一氧化氮(NO)等水平的改变情况。结果治疗3个月后,两组FEV1%和FVC较治疗前均升高,但治疗组较对照组更明显,差异均有统计学意义(P<0.05);两组PAPm、PAPs、血清CRP均较治疗前明显下降、血清NO较治疗前明显升高,治疗组较对照组更显著,其差异均有统计学意义(P<0.05)。结论辛伐他汀能明显改善COPD合并PAH患者的肺功能,并可能通过抑制炎症反应、增加NO含量、改善内皮功能等机制降低肺动脉高压。

Objective To observe the clinical effect of simvastatin in the treatment of patients with chronic obstructive pulmonary disease （COPD） complicated with pulmonary arterial hypertension （PAH）.Methods Eighty patients with COPD complicated with PAH were assigned randomly into two groups：the treatment group and the control group,with 40 cases in each group.The patients in the control group received conventional treatment,while those in the treatment group were given simvastatin besides conventional treatment.The FEV1％,FVC,mean pulmonary artery pressure （PAPm）,systolic pulmonary artery pressure （PAPs）,serum C-reactive protein （CRP） and nitric oxide （NO） level were observed before and after 3 months of treatment.Results After 3 months of treatment,the levels of FEV1％,FVC in the two groups were all significantly improved （P＜0.05）,but the improvement in the treatment group was more significantly than that in the control group （P＜0.05）.PAPm,PAPs and serum CRP decreased significantly in two groups,while NO increased significantly （P＜0.05）.The treatment group improved more significantly than the control group （P＜0.01）.Conclusion Simvastatin can significantly improve lung function and HPH in patients with COPD complicated with PAH.It can reduce pulmonary hypertension through inhibiting inflammatory reaction,increasing the content of NO,and improving endothelial function.