普伐他汀对类风湿关节炎患者炎症反应和内皮功能的影响  

Effects of provastatin treatment on vascular inflammatory reaction and endothelial functions in patients with active rheumatoid arthritis

作　　者：刘宇宏[1] 付倩[2] 沈凌汛[1] 杜戎[1] 王玮炜[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院风湿免疫内科,武汉430022 [2]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《中国免疫学杂志》2009年第5期464-467,共4页Chinese Journal of Immunology

摘　　要：目的:观察普伐他汀对类风湿关节炎(RA)患者炎症反应和内皮功能的影响。方法:40例活动性RA患者随机分为:①慢作用药物组20例;②慢作用药物+普伐他汀治疗组20例;另设健康对照组20例。分别于治疗前和治疗8周后测量血脂、ESR、CRP、IL-1β、IL-6和TNF-α表达水平,用高分辨率超声仪检测肱动脉内皮依赖性和非依耐性舒张功能的变化。结果:与对照组比较,慢作用药物组患者血清CRP和TNF-α明显升高,内皮舒张功能明显受损,且治疗前后差异无显著性。加用普伐他汀治疗后,血清CRP和TNF-α明显降低,血管内皮依赖性舒张功能明显改善。结论:普伐他汀能有效改善类风湿关节炎患者的内皮功能。这种有益作用可能部分与其降低CRP和TNF-α水平、抑制炎症反应有关。Objeclive：To study the effects of provastatin on vascular inflammatory reaction and endothelial functions in patients with active rheumatoid arthritis（RA）. Methods： A total of 40 patients with active RA were randomized into： ①Disease modifying antirheumatoid drug （DMARD） group; ②DMARD plus provastatin group; in addition, ③20 healthy subjects were chosen as control. Before and after 8 weeks＇ therapy, TC, TG, LDL, ESR, CRP, IL-1β, IL-6 and TNF-α were measured, Endothelium -dependent and -independent vasodilation of the Brachial artery were assessed by the brachial ultrasound examination. Results： Compared with those of the healthy control group, Serum CRP and TNF-α were sigaifieantly higher and endothelial function was obviously impaired. All the parameters indicated insignificant changes in patient in DMARD group before and after therapy. 8 weeks after combined provastatin therapy, serum CRP and TNF-α were significantly lower, and endothelium-dependent diastole function of brachial artery was ameliorated significantly as compared with those before treatment. Conclusion： Provastatin can improve endothehal function in patients with RA. Its beneficial effect might be partly associated with the attenuation of the increased CRP and TNF-α level to lower inflammatory response.

关 键 词：普托伐他汀 类风湿关节炎 炎症反应 内皮功能 

分 类 号：R593.22[医药卫生—内科学]