阿托伐他汀钙治疗肺源性心脏病并肺动脉高压的临床研究

目的观察阿托伐他汀钙治疗肺源性心脏病合并肺动脉高压(PAH)的临床疗效及安全性。方法选取肺源性心脏病并PAH患者72例,随机分为他汀组和对照组各36例。两组均给予基础疾病常规治疗+前列地尔,他汀组在此基础上给予阿托伐他汀钙片20 mg/d,每晚1次;对照组给予口服安慰剂:葡萄糖钙片,1片/d,每晚1次。两组患者均治疗3个月。同时选择门诊体检正常者36例为健康组。检测健康组和两组患者治疗前后的血气分析指标、血流动力学指标及生化指标。结果治疗前,两组患者各项指标与健康组比较差异有统计学意义(P0.01),两组患者间的各项指标比较差异无统计学意义(P0.05);治疗3个月后,两组患者的各项指标均较治疗前显著改善(P0.05或P0.01),但他汀组患者的改善更显著(P0.05或P0.01);两组不良反应发生率比较差异无统计学意义(P0.05)。结论阿托伐他汀钙治疗肺源性心脏病并肺动脉高压安全有效,通过抗炎、减少内皮素,提高动脉血氧分压和脉搏血氧浓度,降低肺动脉压。

Atorvastatin calcium in the treatment of pulmonary heart disease complicated with pulmonary hypertension

Objective To investigate the effect and safety of atorvastatin calcium in the treatment of pulmonary heart disease complicated with pulmonary hypertension.Methods Seventy-two patients with pulmonary heart disease and pulmonary hypertension were randomly divided into two groups： the statin group（36 cases） and the control group（36 cases）.Routine therapy plus alprostadil was given to both groups.On the basis,patients in the statin group were given atorvastatin 20 mg/d,once per night;Patients in the control group were given placebo： glucose calcium,1 tablet/d,once per night.Continuous medication for 3 months in both groups.Thirty-six examination of normal people in outpatient were chosen to the healthy group.Blood gas analysis indicators（PaO2,SaO2）,hemodynamic indicators（LVEF,PASP,PADP,MPAP）,biochemical indicators（hs-CRP,ET-1,IL-6） were detected in the healthy group and in both groups before and after treatment.Results Before the treatment,there were significant differences in various indicators between the two groups and the healthy group（P 0.01）,there were no significant differences in various indicators of both groups（P 0.05）.After 3 months,the indicators had significantly improved compared with before treatment in patients of the two groups（P 0.05 or P 0.01）,but patients in the statin group improved more significantly（P 0.05 or P 0.01）;There was no significant difference in incidence of adverse reaction between the two groups（P 0.05）.Conclusion Atorvastatin calcium is safe and effective in the treatment of pulmonary heart disease and pulmonary hypertension,it can improve PaO2 and SaO2,reduce pulmonary artery pressure by anti-inflammatory reaction and reduce endothelin.