阿托伐他汀对慢性阻塞性肺疾病合并肺动脉高压患者血清炎症因子水平、肺功能及右心室重塑的影响

目的 探讨阿伐他汀对慢性阻塞性肺疾病（COPD）合并肺动脉高压患者血清炎症因子水平、肺功能和右心室重塑的影响。方法 将宝鸡市中心医院自2013年12月-2016年12月收治的COPD合并肺动脉高压患者106例作为研究对象，随机分为研究组和对照组，各53例，对照组患者给予常规基础治疗，研究组患者在对照组治疗的基础上加用阿伐他汀进行治疗，连续治疗3个月。检测患者肺功能、右心室重塑功能及炎症因子相关指标，评价两组患者的临床疗效。结果 研究组患者临床总有效率为94.34%，对照组为79.25%，组间比较差异显著（P<0.05）。治疗前两组患者第一秒用力呼气容积（FEV₁）、用力肺活量（FVC）水平比较差异不显著，治疗后研究组患者FVC和FEV₁水平显著高于对照组（P<0.05）。与治疗前比较，两组治疗后舒张末期左心室内径（LVID）、舒张末期左心室后壁厚度（LVPW）、三尖瓣最大反流速度（TRV_max）、右室射血分数（RVEF）均升高，舒张末期右心室内径（RVAD）降低，差异显著（P<0.05）；治疗后研究组指标LVID、LVPW、TRV_max、RVEF高于对照组，RVAD低于对照组，差异显著（P<0.05）。治疗前两组患者C反应蛋白（CRP）、内皮素（ET）和白细胞介素（IL-6）水平比较差异不显著，治疗后研究组患者CRP、ET、IL-6水平降低程度显著优于对照组（P<0.05）。结论 阿伐他汀有效改善COPD联合肺动脉高压患者血清炎症因子水平、肺功能及右心室重塑的影响，临床效果显著，可推广使用。

Effects of atorvastatin on serum levels of inflammatory factors, pulmonary function and right ventricular remodeling in patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension

Objective To investigate the effect of atorvastatin on serum levels of inflammatory cytokines, pulmonary function and right ventricular remodeling in patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension. Methods From December 2013 to December 2016, 106 patients with COPD complicated with pulmonary hypertension were randomly divided into treatment and control groups, each with 53 cases. Patients in control group were treated with routine basic therapy for three months, and patients in treatment group were treated with atorvastatin on the basis of control group. The pulmonary function, right ventricular remodeling function and inflammatory factors were detected, and the clinical efficacy of two groups was evaluated. Results The total effective rate was 94.34% in the treatment group and 79.25% in the control group, difference between the two groups was significant (P<0.05). The levels of FEV₁ and FVC were not significantly different between two groups before treatment. The levels of FVC and FEV₁ in treatment group were significantly higher than those in the control group after treatment (P<0.05). After treatment, the LVED, LVPW, TRV_max and RVEF of treatment group were significantly higher than those of control group (P<0.05), and the difference was statistically significant. Compared with before treatment, LVID, LVPW and TRV_max were increased, RVAD decreased, and the difference was statistically significant (P<0.05). The levels of CRP, ET and IL-6 in the treatment group were significantly lower than those in the control group (P<0.05), and difference was statistically significant. Conclusion The effect of atorvastatin on serum inflammatory factors, pulmonary function and right ventricular remodeling in patients with COPD combined with pulmonary hypertension is significant and can be popularized.