Department of Pharmacology, Bhaskar Medical College, Yenkapally (V), Moinabad (M), R. R. District, Andhra Pradesh, India.
Indian J Pharmacol. 2011 May;43(3):311-5. doi: 10.4103/0253-7613.81511.
To study the effects of N-acetylcysteine (NAC) and atorvastatin on endothelial dysfunction in patients with systemic lupus erythematosus (SLE).
Thirty-two SLE patients and age, sex-matched 10 healthy control subjects were studied. The patients were between 17 and 65 years of age and positive for diagnostic tests, such as antinuclear antibodies (ANA). Photoplethysmogram (PPG) detects the changes in the amount of light absorbed by hemoglobin, which reflects changes in the blood volume. Pulse wave analysis was performed at rest, 30 s, 90 s after shear stress, and 10 min after 300 μm of salbutamol inhalation.
Stiffness index (SI) of patients before the treatment was 8.46±2.78 cm/s and of controls was 6.07±1.4 cm/s (P = 0.002) and that of reflection index (RI) was 73±13 for patients and 65±7 for controls (P = 0.001). The percentage change in RI after salbutamol inhalation for controls and patients were -16±6 and -7±4 (P = 0.001), respectively, indicating the presence of endothelial dysfunction. The percentage decrease in RI after salbutamol inhalation was from -2.36±0.76 to ?7.92±1.46 in patients treated with N-acetylcysteine (NAC, P = 0.007). The percentage decrease in RI after salbutamol inhalation was from ?6.361.21 to -9.92±1.21 in patients treated with atorvastatin (P = 0.05). This indicated the improvement in endothelial function. There was decrease in C-reactive protein (CRP) from 1.03±0.72 mg/dL to 0.52±0.22 mg/dL and that of malondialdehyde (MDA) from 11.20±4.07 nmol/mL to 8.81±2.79 nmol/mL with N-acetylcysteine treatment (P < 0.05). The CRP was decreased from 1.11±0.92 mg/dL to 0.440.16 mg/dL (P = 0.05) and that of MDA was decreased from 9.37±3.29 nmol/mL to 8.51±3.27 nmol/mL after treatment with atorvastatin. It showed improvement in oxidative stress with these treatments.
The presence of arterial stiffness indicated endothelial dysfunction. There was reduction in RI and SI with treatment of N-acetylcysteine and atorvastatin suggesting improvement in endothelial dysfunction. There was decrease in CRP (a marker of inflammation) and MDA after treatment with N-acetylcysteine suggesting improvement in endothelial dysfunction. There was reduction in CRP after treatment with atorvastatin, suggesting improvement in endothelial function. Improvement in endothelial dysfunction is associated with decreased incidence of cardiovascular and cerebrovascular accidents.
研究 N-乙酰半胱氨酸（NAC）和阿托伐他汀对系统性红斑狼疮（SLE）患者内皮功能障碍的影响。
研究了 32 名 SLE 患者和 10 名年龄、性别匹配的健康对照者。患者年龄在 17 至 65 岁之间，并且对核抗体（ANA）等诊断性检测呈阳性。光体积描记术（PPG）检测血红蛋白吸收量的变化，反映血液量的变化。在切变应力后 30s、90s 和吸入 300μm 沙丁胺醇后 10min 进行脉搏波分析。
治疗前患者的僵硬度指数（SI）为 8.46±2.78cm/s，对照组为 6.07±1.4cm/s（P=0.002），反射指数（RI）为 73±13 患者和 65±7 对照组（P=0.001）。对照组和患者吸入沙丁胺醇后 RI 的百分比变化分别为-16±6%和-7±4%（P=0.001），表明存在内皮功能障碍。N-乙酰半胱氨酸（NAC）治疗后，患者吸入沙丁胺醇后 RI 的百分比下降从-2.36±0.76 至-7.92±1.46（P=0.007）。阿托伐他汀治疗后，患者吸入沙丁胺醇后 RI 的百分比下降从-6.36±1.21 至-9.92±1.21（P=0.05）。这表明内皮功能得到改善。N-乙酰半胱氨酸治疗后 C-反应蛋白（CRP）从 1.03±0.72mg/dL 降至 0.52±0.22mg/dL，丙二醛（MDA）从 11.20±4.07nmol/mL 降至 8.81±2.79nmol/mL（P<0.05）。阿托伐他汀治疗后，CRP 从 1.11±0.92mg/dL 降至 0.44±0.16mg/dL（P=0.05），MDA 从 9.37±3.29nmol/mL 降至 8.51±3.27nmol/mL。这些治疗方法显示氧化应激得到改善。
动脉僵硬度的存在表明存在内皮功能障碍。N-乙酰半胱氨酸和阿托伐他汀治疗后 RI 和 SI 降低，表明内皮功能障碍得到改善。N-乙酰半胱氨酸治疗后 CRP（炎症标志物）和 MDA 降低，表明内皮功能障碍得到改善。阿托伐他汀治疗后 CRP 降低，表明内皮功能得到改善。内皮功能障碍的改善与心血管和脑血管意外发生率的降低有关。
