辛伐他汀对慢性阻塞性肺疾病合并肺动脉高压患者血管内皮功能及肺动脉压的影响

目的探讨辛伐他汀对慢性阻塞性肺疾病（COPD）合并肺动脉高压患者血管内皮功能及肺动脉压的影响。方法将60例COPD合并肺动脉高压患者随机分为治疗组和对照组各30例。对照组给予吸氧、抗感染、化痰、平喘等常规治疗,治疗组在对照组治疗基础上加用辛伐他汀治疗。利用彩色多普勒超声心动图检测2组治疗前后肺动脉压的变化,并比较2组肺功能变化及血浆一氧化氮（NO）和内皮素-1（ET-1）水平。结果治疗后,2组肺动脉压均低于治疗前,且治疗组低于对照组,差异均有统计学意义（P〈0.05或P〈0.01）。治疗后2组FEV1和FVC均改善,且治疗组肺功能的改善情况优于对照组,差异均有统计学意义（P〈0.05或P〈0.01）。治疗后,治疗组NO水平较治疗前升高,ET-1水平较治疗前降低,差异均有统计学意义（P〈0.05）;且治疗组NO水平高于对照组,ET-1水平低于对照组,差异均有统计学意义（P〈0.05）。结论在常规吸氧、抗感染等治疗的基础上,联合应用辛伐他汀可显著改善COPD合并肺动脉高压患者的血管内皮功能,降低肺动脉高压。

Impact of simvastatin on vascular endothelial function and pulmonary artery pressure of patient with chrnic obstructive pulmonary disease combined pulmonary artery hypertension

Objective To investigate the impact of simvastatin on vascular endothelial function and pulmonary artery pressure of patient with chrnic obstructive pulmonary disease（COPD） combined pulmonary artery hypertension.Methods 60 cases patients with COPD combined pulmonary artery hypertension were randomly divided into treatment group and control group,each of 30 cases.Control group were given conventional therapy of oxygen uptake,anti-infection,reduce phlegm,relieving asthma,treatment group added simvastatin therapy on basis of control group.Detected the pulmonary artery pressure changes by color doppler ultrasonic cardiogram before and after treatment,and compared the pulmonary function changes,plasma nitric oxide（NO） and endothelin-1（ET-1） level of 2 groups.Results After treatment,both of 2 groups pulmonary artery pressure were lower than before treatment,and the pulmonary artery pressure of treatment group was lower than that of control group,the diffenence were statistically significant（P〈0.05 or P〈0.01）.After treatment,the FEV1and FVC of 2 groups were improved,and the pulmonary function situation of treatment group was better than that of control group,the diffenence were statistically significant（P〈0.05 or P〈0.01）.After treatment,the NO level of treatment group was higher than before treatment,and ET-1 level was lower than before treatment,and NO level of treatment group was higher than that of control group,ET-1 level was lower than that of control group,the diffenence were statistically significant（P〈0.05 or P〈0.01）.Conclusion On basis of conventional therapy of oxygen uptake,anti-infection,the combined application of simvastatin can improve the vascular endothelial function,and lower the pulmonary artery hypertension significantly.