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低剂量(1 毫克/天)匹伐他汀对高血脂患者左心室舒张功能和蛋白尿的影响。

Effect of low-dose (1 mg/day) pitavastatin on left ventricular diastolic function and albuminuria in patients with hyperlipidemia.

机构信息

Department of Cardiovascular Medicine, University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.

出版信息

Am J Cardiol. 2011 Jun 1;107(11):1644-9. doi: 10.1016/j.amjcard.2011.01.054. Epub 2011 Mar 31.

Abstract

The aim of the present study was to evaluate the factors that modulate the protective action of statins on cardiorenal function, regardless of the lipid-lowering effect. To treat abnormal serum lipid profiles, low-dose pitavastatin (1.0 mg/day) was administered to 65 hyperlipidemic patients. The exclusion criteria included left ventricular ejection fraction <40% and apparent renal disease. Age- and gender-matched patients with hyperlipidemia (n = 40) served as the controls. After 12 to 16 weeks of pitavastatin treatment, pitavastatin had decreased low-density lipoprotein cholesterol (from 143.5 ± 31.4 to 98.2 ± 19.4 mg/dl, p <0.01), triglycerides (from 157.7 ± 57.2 to 140.5 ± 60.7 mg/dl, p <0.01), E/e' (from 10.8 ± 6.2 to 9.0 ± 4.5, p <0.05), a parameter of left ventricular diastolic function, and albuminuria (from 47.6 ± 55.9 to 28.5 ± 40.0 mg/g creatinine, p <0.01). Furthermore, pitavastatin decreased serum transforming growth factor-β1 (from 709 ± 242 to 550 ± 299 pg/ml, p <0.01), urinary 8-hydroxy-2'-deoxyguanosine (from 6.6 ± 4.1 to 5.0 ± 3.1 μg/g creatinine, p <0.01), an oxidative stress marker, and increased urinary nitrate and nitrite (from 22.5 ± 14.6 to 29.4 ± 27.6 nmol/g creatinine, p <0.05). No such changes were observed in the controls. Multiple regression analysis in the pitavastatin group revealed the effect of pitavastatin on cardiorenal function was associated with suppression of oxidative stress, but not on low-density lipoprotein cholesterol reduction. In conclusion, pitavastatin decreases E/e' and albuminuria, which is associated with suppression of oxidative stress.

摘要

本研究旨在评估调节他汀类药物对心肾功能的保护作用的因素,而不考虑其降脂作用。为了治疗异常的血清脂质谱,给 65 名高血脂患者服用低剂量的匹伐他汀(1.0 毫克/天)。排除标准包括左心室射血分数<40%和明显的肾脏疾病。年龄和性别匹配的高脂血症患者(n=40)作为对照组。经过 12-16 周的匹伐他汀治疗后,匹伐他汀降低了低密度脂蛋白胆固醇(从 143.5±31.4 降至 98.2±19.4mg/dl,p<0.01)、甘油三酯(从 157.7±57.2 降至 140.5±60.7mg/dl,p<0.01)、E/e'(从 10.8±6.2 降至 9.0±4.5,p<0.05),左心室舒张功能的一个参数,和白蛋白尿(从 47.6±55.9 降至 28.5±40.0mg/g 肌酐,p<0.01)。此外,匹伐他汀降低了血清转化生长因子-β1(从 709±242 降至 550±299pg/ml,p<0.01)、尿 8-羟基-2'-脱氧鸟苷(从 6.6±4.1 降至 5.0±3.1μg/g 肌酐,p<0.01),一种氧化应激标志物,和增加尿硝酸盐和亚硝酸盐(从 22.5±14.6 增至 29.4±27.6nmol/g 肌酐,p<0.05)。对照组没有观察到这些变化。匹伐他汀组的多元回归分析显示,匹伐他汀对心肾功能的影响与抑制氧化应激有关,而与降低低密度脂蛋白胆固醇无关。总之,匹伐他汀降低了 E/e'和白蛋白尿,这与抑制氧化应激有关。

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