Amirzargar Mohammad A, Hosseini Arsha Tafreshi, Gholiaf Mahmood, Dadras Farahnaz, Khoshjoo Farhad
Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
Saudi J Kidney Dis Transpl. 2015 Sep;26(5):953-7. doi: 10.4103/1319-2442.164576.
Statins are a class of drug that can efficiently reduce the level of low-density lipoprotein (LDL) as well as increase the LDL receptors. Several non-lipid-lowering effects of this type of drug have been described. It is reported that they have an influence in preventing graft rejection, especially of the acute type. In this study, patients with end-stage renal disease and candidates for kidney transplantation were divided into two groups. Group A (intervention group) received atorvastatin for two weeks prior to their transplant surgery while group B (control group) received placebo. The lipid profile was tested (triglycerides, cholesterol, LDL) in all patients two weeks before the transplantation. After transplantation, drug use was stopped. We also checked the LDL serum levels in patients with raised lipid levels (LDL >100) every two weeks. After this period, the serum lipid levels were checked monthly up to six months. Hyperlipidemia, when present, was controlled by fibrates. Concerning the rejection episodes, there was no significant difference between the two groups. In group A (13 men and nine women), three (14.3%) cases of rejection were observed whereas four (21.3%) cases of rejection were seen in group B (11 men and 10 women) (P = 0.5). Within group A, five (22.7%) cases of delayed graft function were found while four (19%) similar cases were observed in group B (P = 0.7). There was no statistically significant difference concerning delayed graft function between the two groups. Despite all the mechanisms attributed to the probable anti-rejection properties of statins, we found no significant correlation with the administration of these drugs before transplantation and the protection against graft rejection episodes.
他汀类药物是一类能够有效降低低密度脂蛋白（LDL）水平并增加LDL受体的药物。这类药物的几种非降脂作用已被描述。据报道，它们在预防移植排斥反应，尤其是急性排斥反应方面有影响。在本研究中，终末期肾病患者和肾移植候选者被分为两组。A组（干预组）在移植手术前两周接受阿托伐他汀治疗，而B组（对照组）接受安慰剂。在移植前两周对所有患者进行血脂检测（甘油三酯、胆固醇、LDL）。移植后停止用药。我们还每两周检查一次血脂水平升高（LDL>100）患者的血清LDL水平。在此期间过后，每月检查血清脂质水平直至六个月。高脂血症若存在则用贝特类药物控制。关于排斥反应发作，两组之间没有显著差异。在A组（13名男性和9名女性）中，观察到3例（14.3%）排斥反应，而在B组（11名男性和10名女性）中观察到4例（21.3%）排斥反应（P = 0.5）。在A组中，发现5例（22.7%）移植肾功能延迟，而在B组中观察到4例（19%）类似情况（P = 0.7）。两组之间在移植肾功能延迟方面没有统计学上的显著差异。尽管他汀类药物可能的抗排斥特性有各种机制，但我们发现移植前使用这些药物与预防移植排斥反应发作之间没有显著相关性。
