Kaczmarek Przemysław, Sładek Krzysztof, Skucha Wojciech, Rzeszutko Marcin, Iwaniec Teresa, Dziedzina Sylwia, Szczeklik Andrzej
2nd Department of Internal Medicine, Jagiellonian University School of Medicine, Kraków, Poland.
Pol Arch Med Wewn. 2010;120(1-2):11-7.
There is growing evidence that chronic obstructive pulmonary disease (COPD) is a risk factor for coronary heart disease. Simvastatin is a hypolipemic drug with proven efficacy in the prevention of cardiovascular diseases. Observational studies showed that statins may be useful in the reduction of mortality from COPD. Experimental studies on animals showed anti-inflammatory effects of statins on the lung tissue.
The aim of this study was to evaluate the influence of simvastatin on inflammatory markers in patients with COPD.
Fifty-six patients (aged 44-80 years) with stable COPD (a mean forced expiratory volume in 1 second [FEV1] 55%), were randomly assigned (1:1) to receive simvastatin 40 mg/day or to receive no statin treatment. Blood samples were collected before, 2 weeks, and 3 months after statin administration. The levels of fibrinogen, C-reactive protein (CRP), tumor necrosis factor-alpha, interleukin 6 (IL-6), and matrix metalloproteinase-9 were measured.
The groups did not differ significantly in terms of demographic data, clinical symptoms, pharmacological treatment, spirometry, and lipid profile at baseline. Among comorbidities only arterial hypertension was more frequent in the statin group (32.1% vs. 17.9%, P = 0.03). After 2 weeks as well as 3 months of simvastatin treatment, no significant reduction of any measured inflammatory markers was observed. There was a nonsignificant reduction of CRP and IL-6 in the subgroup with FEV1 >50% during simvastatin treatment. There was a decrease in total cholesterol (from 5.7 to 4.7 mmol/l, P = 0.0018) and low-density lipoprotein cholesterol (from 3.46 to 2.47 mmol/l, P = 0.000037) in the statin group.
In COPD patients, a 3-month treatment with simvastatin does not reduce circulating inflammatory markers.
越来越多的证据表明，慢性阻塞性肺疾病（COPD）是冠心病的一个危险因素。辛伐他汀是一种降血脂药物，在预防心血管疾病方面已证实有效。观察性研究表明，他汀类药物可能有助于降低COPD的死亡率。对动物的实验研究表明，他汀类药物对肺组织有抗炎作用。
本研究的目的是评估辛伐他汀对COPD患者炎症标志物的影响。
56例年龄在44 - 80岁之间、稳定期COPD（第1秒用力呼气容积[FEV1]平均为55%）患者被随机（1:1）分配接受40毫克/天辛伐他汀治疗或不接受他汀类药物治疗。在服用他汀类药物前、2周和3个月后采集血样。检测纤维蛋白原、C反应蛋白（CRP）、肿瘤坏死因子-α、白细胞介素6（IL-6）和基质金属蛋白酶-9的水平。
两组在基线时的人口统计学数据、临床症状、药物治疗、肺功能测定和血脂谱方面无显著差异。在合并症中，仅他汀类药物组动脉高血压更为常见（32.1%对17.9%，P = 0.03）。辛伐他汀治疗2周及3个月后，未观察到任何检测的炎症标志物有显著降低。在FEV1>50%的亚组中，辛伐他汀治疗期间CRP和IL-6有非显著降低。他汀类药物组总胆固醇（从5.7降至4.7毫摩尔/升，P = 0.0018）和低密度脂蛋白胆固醇（从3.4降至2.4毫摩尔/升，P = 0.000037）降低。
在COPD患者中，3个月的辛伐他汀治疗不能降低循环炎症标志物水平。
