炎症因子对他汀类药物降脂疗效的影响  

lnflanulmtory cytokines and lipid-lowering effect of statins

作　　者：余渊[1] 

机构地区：[1]重庆医科大学附属第二医院肾内科,400010

出　　处：《国际移植与血液净化杂志》2015年第2期33-35,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的比较他汀类药物在单纯高脂血症和慢性炎症性疾病伴高脂血症患者中的调脂治疗疗效，探讨炎症与脂代谢紊乱之间的关联。方法选择于我院住院或门诊血脂指标异常患者53例，根据患者是否具有慢性炎症性原发疾病将其分为对照组（单纯高脂血症组，n=34）、结缔组织病组（n=9）、原发性慢性肾脏疾病组（CKD组，n=10）。各组患者均采用普伐他汀钠（20mg／d）口服治疗8周。于用药前和用药后2、4、8周分别空腹留取静脉血10ml检测TC、TG、HDL、LDL、IL-6、hs-CRP、BUN、SCr、TB、Alb、ALT及AST。结果各组患者用药前的血脂指标（TC、LDL、HDL、TG）间无显著差异。结缔组织病组和CKD组患者血清炎症因子（IL-6、hs．CRP）的水平显著高于对照组（P〈0．05）。对照组用药后各时间点TC和LDL与用药前比较均有显著下降（P〈0．05）。在CKD和结缔组织病组中，患者的炎症因子（IL-6、hs-CRP）水平显著升高，普伐他汀钠治疗后患者TC和LDL均无显著下降（P〉0．05）。结论具有慢性炎症性疾病伴高脂血症的患者体内炎症因子处于高水平状态。炎症因子对他汀类药物的降脂作用可能有抑制作用。Objective To explore the relationship between inflammation and lipid metabolism by comparing the effections of statins in simple hyperlipidemia and chronic inflammatory disease with hyperlipidemia in patients. So we can offer some clinical basis for appropriate lipid lowering therapy. Melhods A total of 53 eases of patients with abnormal serum lipids were divided into three groups according to whether patients with chronic inflammatory primary diseases： control group（pure hypercholesterolemia Group）, connective tissue disease group and CKD group. Pravastatin sodium（20 mg/d）were given to each patients. TC, TG, HDL, LDL, IL-6, hs-CRP ,BUN, Cr,TB,Alb, ALT, AST were detected after 2,4,8 weeks, respectively. Results Lipid parameters （TC, LDL, HDL, TG） had no significant difference between the three group before treatment. The level of IL-6, hs-CRP were significantly increased in connective tissue disease group and CKD group as compared to the normal control group（ P 〈 0.05）. Level of TC,LDL decreased significantly in control group after treatment, and the lower rate was greater than the other two groups （P 〈 0.05 ）. TC and LDL level in connective tissue disease and CKD group had no significant decline after treatment with the highest levels of inflammatory factors. Conslusion Patients with chronic inflammatory hyperlipidemia disease has a high level of inflammatory cytokines, and they might inhibit the role of lipid-lowering statin drugs.

关 键 词：炎症因子 他汀类药物 降脂治疗 

分 类 号：R541.4[医药卫生—心血管疾病]