摘要
目的观察阿托伐他汀在治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者中的临床价值并分析其可能的作用机制。方法选择稳定期COPD合并PH患者45例、单纯性COPD患者40例,将45例COPD合并PH患者分为阿托伐他汀治疗组(23例)和对照组(22例)。比较治疗后两组血清中8-异前列腺素(8-iso-PG)、白介素-6(IL-6)水平及相关临床指标。结果单纯性COPD组、COPD合并PH组血清中IL-6水平分别为(43.58±13.38)ng/L和(72.80±21.60)ng/L,差异有统计学意义(P<0.01);两组血清中8-iso-PG水平分别为(27.79±11.09)ng/L与(41.87±9.75)ng/L,差异有统计学意义(P<0.01)。COPD合并PH患者血清IL-6和8-iso-PG水平与PASP呈正相关。阿托伐他汀治疗6个月后,治疗组血清8-iso-PG、IL-6、PASP较同组治疗前及对照组治疗后均有降低(P<0.01),PaO2、6MWD较同组治疗前及对照组治疗后均有升高(P<0.05)。结论阿托伐他汀能降低COPD合并PH患者肺动脉压力,改善血氧含量和运动耐力,其机制可能与其抑制炎症反应与氧化应激有关。
Objective To explore the clinical efficacy of atorvastatin in treatment of patients with chronic obstructive pulmonary disease（COPD） combined with pulmonary hypertension（PH）and its mechanism. Methods Forty patients with COPD and forty-five with stable COPD combined with PH were enrolled in this study. Forty-five patients with COPD combined with PH were randomly divid- ed into atorvastatin group （n = 23 ）and control group （n = 22）. The changes of pulmonary arterial systolic pressure （PASP）, FEV1 , FVC, PO2, PCO2,6 - minute walking distance （6MWD）, the plasma levels of cholesterol, triglycerides, IL-6 and 8-iso-PG were measured af- ter treatment. Results The plasma level of IL-6 was significantly higher in patients with COPD combined with PH group than that in patients with COPD group [ （72.80 ± 21.60） ng/L vs （43.58 ±13.38 ） ng/L , P 〈 0.01 ]. Compared with COPD group, a significant increase in the level of 8-iso-PSG was observed in COPD combined with PH group [ （27.79 ±11.09） vs （41.87 ±9.75 ） ng/L, P 〈 0. 01 ]. The plasma levels of IL-6 and 8-iso-PG in COPD combined with PH group were positively correlated with pulmonary artery sys- tolic pressure（PASP） ,but negatively with PaO2 and 6MWD. The levels of IL-6 and 8-iso-PG in serum. PASP was significantly lower in atorvastatin group than in control group after 6 - month treatment, and the 6MWD and PaO2 were significantly higher（ P 〈 0.05 ）. Conclusion Atorvastatin can obviously reduce PASP, and improve arterial oxygen partial pressure and exercise tolerance of COPD pa- tients combined with PH, which may be caused by atorvastatin inhibiting the inflammatory reaction and oxidative stress.
出处
《山西医科大学学报》
CAS
2014年第3期204-208,共5页
Journal of Shanxi Medical University
基金
南通市科技计划基金资助项目(HS2011038)
关键词
慢性阻塞性肺疾病
肺动脉高压
炎症
氧化应激
白介素-6
8-异前列腺素
chronic obstructive pulmonary disease
pulmonary hypertension
inflammation
oxidative stress
interleukin-6
8-iso-prostaglandin
