阿托伐他汀 40 毫克与 10 毫克对缺血性心肌病患者氧化型低密度脂蛋白、高敏 C 反应蛋白、循环内皮细胞来源的微囊泡和内皮祖细胞的影响。
Effect of 40 mg versus 10 mg of atorvastatin on oxidized low-density lipoprotein, high-sensitivity C-reactive protein, circulating endothelial-derived microparticles, and endothelial progenitor cells in patients with ischemic cardiomyopathy.
机构信息
Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
出版信息
Clin Cardiol. 2012 Feb;35(2):125-30. doi: 10.1002/clc.21017. Epub 2012 Jan 23.
BACKGROUND
There are few recent data to delineate the beyond lipids-decreased effect of statins and the effect of different doses of statins on endothelial-derived microparticles (EMPs) and circulating endothelial progenitor cells (EPCs) in patients with ischemic cardiomyopathy (ICM).
HYPOTHESIS
Statins might have the beyond lipids-decreased effect and there were different effects between different doses of statins on EMPs and circulating EPCs in patients with ICM.
METHODS
One hundred patients with ICM and 100 healthy examined people, who served as the normal control group, were recruited to this study. Patients were randomly divided into 2 groups: 10-mg atorvastatin group (n = 50) and 40-mg atorvastatin group (n = 50). All subjects were followed for 1 year. The levels of serum lipids, oxidized low-density lipoprotein (oxLDL), high-sensitivity C-reactive protein (hsCRP), circulating EPCs, and EMPs were examined in all subjects. The incidences of adverse reactions in the 2 study groups were determined.
RESULTS
At the beginning of this study, there were no significant differences in baseline characteristics between the 2 study groups. At the end of this study, the levels of total cholesterol, low-density lipoprotein, serum hsCRP, oxLDL, and circulating EMPs were significantly decreased; circulating EPCs were significantly increased in the 40-mg atorvastatin group compared to the 10-mg atorvastatin group, P < 0.05. The multivariate linear regression analysis indicated that receiving only 40 mg of atorvastatin had a significant effect on the levels of circulating EPCs (β = 0.252,P = 0.014). There were no significant differences in the adverse reactions between the 2 groups.
CONCLUSIONS
Use of 40 mg of atorvastatin might decrease the levels of circulating EMPs and increase the number of circulating EPCs in patients with ICM in comparison with 10 mg of atorvastatin, and the effect might be independent of the decrease of lipids, oxLDL, and hsCRP.
背景
目前关于他汀类药物的降脂作用以外的效果，以及不同剂量他汀类药物对缺血性心肌病（ICM）患者内皮衍生的微颗粒（EMP）和循环内皮祖细胞（EPC）的影响，鲜有最新数据。
假说
他汀类药物可能具有降脂作用以外的效果，并且不同剂量的他汀类药物对 ICM 患者的 EMP 和循环 EPC 有不同的影响。
方法
本研究纳入 100 例 ICM 患者和 100 例健康体检者作为正常对照组。患者被随机分为 2 组：10mg 阿托伐他汀组（n=50）和 40mg 阿托伐他汀组（n=50）。所有患者均随访 1 年。所有患者均检测血清脂质、氧化型低密度脂蛋白（oxLDL）、高敏 C 反应蛋白（hsCRP）、循环 EPC 和 EMP 水平。观察两组患者不良反应的发生情况。
结果
本研究开始时，两组患者的基线特征无显著差异。研究结束时，与 10mg 阿托伐他汀组相比，40mg 阿托伐他汀组总胆固醇、低密度脂蛋白、血清 hsCRP、oxLDL 和循环 EMP 水平显著降低，循环 EPC 水平显著升高，差异有统计学意义（P<0.05）。多变量线性回归分析表明，仅服用 40mg 阿托伐他汀对循环 EPC 水平有显著影响（β=0.252，P=0.014）。两组患者不良反应发生率无显著差异。
结论
与 10mg 阿托伐他汀相比，使用 40mg 阿托伐他汀可降低 ICM 患者循环 EMP 水平，增加循环 EPC 数量，这种作用可能独立于血脂、oxLDL 和 hsCRP 的降低。
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