瑞舒伐他汀对血脂正常阻塞性睡眠呼吸暂停综合征合并高血压患者血栓前状态的影响

目的 研究瑞舒伐他汀对血脂正常的阻塞性睡眠呼吸暂停综合征（OSAS）合并高血压患者血栓前状态的影响.方法 血脂正常的OSAS合并高血压患者75例,随机分成瑞舒伐他汀组40例,常规治疗组35例,另选取25名门诊健康体检者作为对照组.检测一氧化氮（NO）、内皮素（ET-1）及血管性假性血友病因子（vWF）、血小板颗粒膜蛋白（GMP-140）、组织型纤溶酶原激活剂（t-PA）、纤溶酶原激活物抑制剂-1（PAI-1）的水平变化.结果 ①治疗前两组OSAS合并高血压患者NO、t-PA低于健康对照组,差异有统计学意义（P＜0.05）；ET-1、vWF、GMP-140、PAI-1水平均高于健康对照组,差异有统计学意义（P＜0.01）.②治疗后瑞舒伐他汀组及常规治疗组NO、t-PA水平均较治疗前升高,瑞舒伐他汀组NO、t-PA高于常规治疗组,差异有统计学意义（P＜0.05）.③治疗后瑞舒伐他汀组及常规治疗组ET-1及vWF、GMP-140、PAI-1均较治疗前降低,瑞舒伐他汀组ET-1、vWF,GMP-140低于常规治疗组,差异有统计学意义（P＜0.01）.结论 对于血脂正常的OSAS合并高血压患者,瑞舒伐他汀可通过提高血浆NO、t-PA浓度和降低ET-1、vWF、GMP-140、PAI-1浓度等非调脂机制改善血栓前状态.

Effect of rosuvastatin on prothrombotic state in OSAS patients with hypertension without hyperlipemia

Objective To investigate the effect of rosuvastatin on prothrombotic state in OSAS pa- tients with hypertension without hyperlipemia. Methods Seventy-five OSAS patients with hypertension with- out hyperlipemia were enrolled and randomly divided into rosuvastatin group and conventional treatment group （oral taken rosuvastatin or placebo once every night in addition of routine antihypertensive drugs ）. Twenty five healthy subjects were also recruited as control.An cases were followed up for eight weeks. Serum holesterol, nitric oxide （ NO ）, emdothelin - 1 （ ET- 1 ） and vonWillebrand -factor （vWF）, -granule membrane protein （GMP-140） , and PAI-1 ,t-PA levels were determined in each case before and after eight weeks ro- suvastatin medication. Results （1）Before treatment NO, t-PA levels of OSAS patients with hypertension without hyperlipemia group were lower than the healthy group the difference was statistically significant （P〈 0.05）. ET-1 and vWF,GMP-140,PAI-1 levels of the two OSAS groups were higher than those of control group, the difference was statistically significant （P〈0.01）. （2）After treatment of rosuvastatin, NO,t-PA lev- els in rosuvastatin group and conventional treatment group increased compared with before treatment, but ro- suvastatin group increased more significantly, the difference was statistically significant （P〈0.05）. （3）ET-1 and vWF, GMP-140, PAI-levels in rosuvastatin treatment and conventional treatment group were lower than before treatment, but in rosuvastatin group they were significantly lower after treatment, the difference was statistically significant （P〈O.01）. Conclusion In patients of OSAS patients with hypertension without hyper- lipemia, msuvastatin can increase plasma NO ,t-PA concentration and decrease ET-1, vWF ,GMP-140,andPAI-1 concentration and thus to improve the prothrombotic status.