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培哚普利可进一步降低高血压伴高胆固醇血症患者经血管紧张素Ⅱ 1 型受体拮抗剂治疗后的血清高敏 C 反应蛋白水平。

Pitavastatin further decreases serum high-sensitive C-reactive protein levels in hypertensive patients with hypercholesterolemia treated with angiotensin II, type-1 receptor antagonists.

机构信息

Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, Moriguchi, Japan.

出版信息

Clin Exp Hypertens. 2010;32(6):341-6. doi: 10.3109/10641961003628460.

Abstract

Lipid-lowering therapy with a statin not only powerfully lowers cholesterol but also exerts anti-inflammatory effects by decreasing serum C-reactive protein (CRP). Since an angiotensin II, type-1 receptor antagonist (ARB) also decreases CRP levels, the add-on effect of statins on CRP may be worth exploring. We determined the effect of pitavastatin on serum levels of highly sensitive CRP (hs-CRP) in 30 patients with hypercholesterolemia undergoing treatment with anti-hypertensive medication including ARBs. Pitavastatin, 2 mg daily, was given. The control group consisted of hypertensive patients without hyperlipidemia. The low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and hs-CRP were measured at baseline, 1, 3, 6, and 12 months after treatment. For the atherosclerotic index, LDL-C/HDL-C ratios at 12 months were calculated. The LDL-C level was markedly reduced at 1 month and thereafter. The baseline level of hs-CRP in the hyperlipidemia group was significantly higher than that in the control group (1.647 ± 0.210 mg/L vs. 0.666 ± 0.097 mg/L p < 0.0001). After 3 months, the percentage of reduction of hs-CRP was significantly higher than that in the control group. The absolute values of hs-CRP were significantly decreased to a level similar to the control group, and the hs-CRP in both groups was remained at the same level for 12 months. Although the LDL-C/HDL-C ratios of the pitavastatin group was significantly reduced from 3.3 to 1.8, those of the control group were not changed. In conclusion, pitavastatin was found to have powerful anti-inflammatory, add-on effects over the similar effects of ARB as assessed by hs-CRP.

摘要

他汀类药物降脂治疗不仅能强力降低胆固醇,还通过降低血清 C 反应蛋白(CRP)发挥抗炎作用。由于血管紧张素 II 型 1 型受体拮抗剂(ARB)也能降低 CRP 水平,他汀类药物对 CRP 的附加作用可能值得探讨。我们观察了匹伐他汀对 30 例正在接受包括 ARB 在内的降压药物治疗的高胆固醇血症患者的血清高敏 CRP(hs-CRP)水平的影响。给予患者匹伐他汀 2mg/d。对照组为无高脂血症的高血压患者。分别在基线、治疗 1、3、6 和 12 个月时检测低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和 hs-CRP。计算 12 个月时 LDL-C/HDL-C 比值作为动脉粥样硬化指数。LDL-C 在 1 个月时明显降低,此后持续降低。高脂血症组 hs-CRP 的基线水平显著高于对照组(1.647±0.210mg/L vs. 0.666±0.097mg/L,p<0.0001)。治疗 3 个月后,hs-CRP 的降低百分比显著高于对照组。hs-CRP 的绝对值显著降低至与对照组相似的水平,且两组的 hs-CRP 水平在 12 个月时保持相同。尽管匹伐他汀组的 LDL-C/HDL-C 比值从 3.3 显著降低至 1.8,但对照组的 LDL-C/HDL-C 比值没有变化。总之,匹伐他汀被发现具有强大的抗炎作用,hs-CRP 评估结果表明其具有与 ARB 相似的附加作用。

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