Isma Nazim, Barani Jamal, Mattiasson Ingrid, Lindblad Bengt, Gottsäter Anders
University of Lund, Department of Vascular Diseases, Malmö University Hospital, Malmö, Sweden.
Angiology. 2008 Oct-Nov;59(5):542-8. doi: 10.1177/0003319707306144. Epub 2008 Apr 2.
To evaluate relationships between lipid-lowering therapy, inflammation, and 3-year mortality in critical limb ischemia (CLI), 259 consecutive CLI patients underwent evaluation of medication, tumor necrosis factor-alpha, interleukin-6 (IL-6), neopterin, high-sensitivity C-reactive protein (hs-CRP), 8-epi-PGF(2 alpha), and endothelin-1. Mortality was assessed after 3 years. Sixty-one patients (24%) were on lipid-lowering therapy and 59 patients (97%) on statins. Patients on lipid-lowering therapy were younger and showed lower low-density lipoprotein cholesterol, hs-CRP, and IL-6 levels than patients without therapy. Three-year survival was higher among patients on lipid-lowering therapy. In logistic regression, the effect of lipid-lowering therapy on 3-year survival was significant with inflammatory markers entered into the model one by one but disappeared when all inflammatory markers were entered into the model together. In conclusion, hs-CRP and IL-6 levels were lower and 3-year survival was higher in CLI patients on lipid-lowering therapy.
为评估降脂治疗、炎症与严重肢体缺血(CLI)患者3年死亡率之间的关系,259例连续的CLI患者接受了药物、肿瘤坏死因子-α、白细胞介素-6(IL-6)、蝶呤、高敏C反应蛋白(hs-CRP)、8-表前列腺素F2α(8-epi-PGF2α)和内皮素-1的评估。3年后评估死亡率。61例患者(24%)接受降脂治疗,59例患者(97%)服用他汀类药物。接受降脂治疗的患者比未接受治疗的患者更年轻,低密度脂蛋白胆固醇、hs-CRP和IL-6水平更低。接受降脂治疗的患者3年生存率更高。在逻辑回归分析中,逐一将炎症标志物纳入模型时,降脂治疗对3年生存率的影响显著,但当所有炎症标志物一起纳入模型时,该影响消失。总之,接受降脂治疗的CLI患者hs-CRP和IL-6水平较低,3年生存率较高。