不同剂量阿托伐他汀对缺血性心肌病患者血清8-OHdG水平的影响

Effects of Different Doses of Atorvastatin on 8-OHdG Levels in Serum of Patients with Ischemic Cardiomyopathy

目的比较20 mg与40 mg阿托伐他汀对缺血性心肌病(ischemic cardiomyopathy,ICM)患者血清8-羟基脱氧鸟嘌呤(8-hydroxy deoxyguanosine,8-OHdG)水平的影响。方法按随机数字表法将246例患者分为两组:阿托伐他汀20 mg/d治疗组(20 mg治疗组,n=124)和40 mg/d治疗组(40 mg治疗组,n=122)。1年随访期。结果患者均完成1年随访,在随访期内两组药物应用方面差异无显著性差异(P>0.05),两组横纹肌溶解、药物性肝炎及其他不良反应比较差异无统计学意义(P>0.05)。组内比较:两组患者总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)均较治疗前明显降低(P<0.05);治疗后,40 mg治疗组超敏-C反应蛋白(high-sensitive Creactive protein,hs-CRP)、脑利钠肽(brain natriuretic peptide,BNP)和8-Ohd G水平明显低于治疗前,差异具有统计学意义(P<0.05)。组间比较:治疗后40 mg治疗组的hs-CRP、BNP和8-OHdG较20 mg治疗组明显降低,差异有统计学意义(P<0.05)。结论阿托伐他汀的抗氧化作用与剂量存在关系,40 mg阿托伐他汀较20 mg阿托伐他汀的抗氧化作用明显。

Objective To investigate the differences between 20 mg and 40 mg atorvastatin in patients with ische- mic cardiomyopathy （ICM） on 8-hydroxy deoxyguanosine （8-OHdG）. Methods A total of 246 hospitalized ICM patients were divided into 20 mg/d （20 mg treatment group, n = 124） and 40 mg/d （40 mg treatment group, n = 122） atorvastatin treatment groups in accordance with the random number. The adverse drug reactions were recorded during a one-year fol- low-up. Results All ICM patients were followed up for 1 year. No significant differences were found in the drug use, drug-induced liver disease, rhabdomyolysis and other adverse drug reactions between two groups （P〉0. 05）. Intra-group comparison showed the total cholesterol （TC） and low-density lipoprotein cholesterin （LDL-C） decreased （P〈0. 05）. The levels of 8-OHdG, high-sensitive c-reactive protein （hs-CRP） and brain natriuretic peptide （BNP） after treatment re- duced in 40 mg/d atorvastatin treatment group （P〈0. 05）. Intra-group comparison showed the levels of 8-OHdG, hs- CRP and BNP in 40 mg/d treatment group were significantly less than these in 20 mg/d treatment group after treatment （P（0. 05）. Conclusion Differents doses of atorvastatin do exist differences in antioxidation. Levels of 8-OHdG in 40 mg/d atorvastatin treatment group are obviously lower than these in 20 mg/d atorvastatin treatment group.