阿托伐他汀钙片有效降低短病程Graves眼病患者的血清肿瘤坏死因子水平  

Atorvastatin Reduces Serum Tumor Necrosis Factor-alpha Levels in Patients with Short-course Graves Ophthalmopathy

作　　者：杨诗琦 刘建英 章燕[1,2,3] YANG Shi-Qi;LIU Jian-ying;ZHANG Yan(Department of Endocrinology&Metabolism,the Affiliated Hospital of Nanchang University;Jiangxi Clinical Research Center for Endocrine&Metabolic Disease;Jiangxi Branch of National Clinical Medical Research Center for Metabolic Diseases,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院内分泌代谢科 [2]江西省内分泌代谢病临床医学研究中心 [3]国家代谢性疾病临床医学研究中心,南昌330006

出　　处：《实用临床医学（江西）》2024年第4期6-10,共5页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(SKJP220229400)。

摘　　要：目的分析阿托伐他汀治疗对于Graves眼病(GO)患者血清肿瘤坏死因子α(TNF-α)水平的影响,探索阿托伐他汀钙片对GO患者疗效及安全性。方法选取2022年8月至2023年3月在南昌大学第一附属医院内分泌科门诊就诊或住院的60例GO患者作为研究对象,按其病程长短分为长病程组(病程>2年,n=30)和短病程组(病程<2年,n=30)。2组均在抗甲状腺药物治疗同时服用阿托伐他汀钙片20 mg·d^(-1),观察比较2组治疗前及治疗后2个月的血清TNF-α水平、突眼度,以及甲状腺功能、促甲状腺激素受体抗体、肝功能、空腹血糖、血脂的变化情况及药物相关不良反应。结果与治疗前短病程组患者的血清TNF-α均值高于长病程组(9.43±0.52 pg·mL^(-1)vs7.53±0.27pg·mL^(-1),P<0.05)。治疗后2个月,短病程组TNF-α水平较治疗前下降(9.43±0.52 pg·mL^(-1)vs 8.17±0.41 pg·mL^(-1),P<0.05),而长病程组患者的TNF-α水平无明显变化(7.53±0.27 pg·mL^(-1)vs8.18±0.54pg·mL^(-1),P=0.173)。治疗前后两组突眼度均无明显变化(P>0.05)。短病程组患者FT4降低(1.53±1.16 ng·dL^(-1)vs1.17±0.08ng·dL^(-1),P=0.016),FT3、TSH、TRAb均无明显变化(P>0.05),长病程组患者FT3、FT4、TSH、TRAb均无明显变化(P>0.05)。长病程组出现转氨酶升高的患者比例高于短病程组,长病程5例(16.7%,5/30),短病程组1例(3.3%,1/30),但均在正常值上限范围之内,所有患者治疗过程中均未出现肌肉酸痛、肌痛、无力、僵硬和肌肉痉挛症状。结论阿托伐他汀钙片联合抗甲状腺药物治疗可显著降低短病程Graves眼病患者血清TNF-α水平,但突眼度改善并不显著,对长病程(病程>2年)患者血清TNF-α无影响。Objective To analyze the effect of atorvastatin on serum tumor necrosis factor-alpha(TNF-α)levels in patients with Graves’ophthalmopathy(GO),and to explore the efficacy and safety of atorvastatin calcium tablets in patients with GO.Methods 60 GO patients who visited the outpatient clinic or were hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Nanchang University from August 2022 to March 2023 were selected as the study subjects,and were divided into the long course group(with a disease course of>2 years,n=30)and the short course group(with a disease course of<2 years,n=30).Both groups were given atorvastatin calcium tablet 20 mg·d^(-1) in combination with antithyroid drug therapy.The changes of serum TNF-αlevels,exophthalmos degree,thyroid functions,thyroid stimulating hormone receptor antibody,liver functions,fasting blood glucose,blood lipid and drug-related adverse reactions were observed and compared before and 2 months after medication.Results The mean values of serum TNF-αin the short course group before treatment were higher than those in the long course group(9.43±0.52 pg·mL^(-1) vs 7.53±0.27 pg·mL^(-1),P<0.05);after 2 months of treatment,the levels of TNF-αin the short course group were decreased compared with those before treatment(9.43±0.52 pg·mL^(-1) vs 8.17±0.41 pg·mL^(-1),P<0.05),whereas there were no significant changes in the TNF-αlevels in the long course group(7.53±0.27 pg·mL^(-1) vs 8.18±0.54 pg·mL^(-1),P=0.173);there were no significant changes in exophthalmos degree between the 2 groups before and after treatment(P>0.05);in the short course group,FT4 were decreased(1.53±1.16 ng·dL^(-1) vs 1.17±0.08 ng·dL^(-1),P=0.016),and there were no significant changes in FT3,TSH and TRAb(P>0.05),whereas there were no significant changes in FT3,FT4,TSH and TRAb in the long course group(P>0.05);the proportion of patients with elevated transaminase in the long course group was higher than that in the short course group,with 5 cases(16.7%,5/30)in the

关 键 词：GRAVES眼病 突眼 阿托伐他汀钙片 肿瘤坏死因子 

分 类 号：R771.3[医药卫生—眼科] R581[医药卫生—临床医学]