Wang Lei, Yang Ting, Wang Chen
Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Department of Respiratory Medicine, Capital Medical University, Beijing 100069, China.
Chronic Dis Transl Med. 2017 Dec 11;3(4):213-220. doi: 10.1016/j.cdtm.2017.10.001. eCollection 2017 Dec.
Pulmonary hypertension (PH) is a condition characterized by vasoconstriction and vascular remodeling with a poor prognosis. The current medical treatments available are supportive care therapy and pulmonary vascular-targeted therapy. Targeted treatments for PH include prostacyclin analogs, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors; however, these treatments cannot reverse pulmonary vascular remodeling. Recently, many novel treatment options involving drugs such as statins have been emerging. In this review, we attempt to summarize the current knowledge of the role of statins in PH treatment and their potential clinical effects. Many basic researches have proved that statins can be helpful for the treatment of PH both and in experimental models. The main mechanisms underlying the effects of statins are restoration of endothelial function, attenuation of pulmonary vascular remodeling, regulation of gene expression, regulation of intracellular signaling processes involved in PH, anti-inflammatory responses, and synergy with other targeted drugs. Nevertheless, clinical researches, especially randomized controlled trials for PH are rare. The current clinical researches show contrasting results on the clinical effects of statins in patients with PH. Carefully designed randomized, controlled trials are needed to test the safety and efficacy of statins for PH treatment.
肺动脉高压（PH）是一种以血管收缩和血管重塑为特征且预后不良的疾病。目前可用的医学治疗方法是支持性护理疗法和肺血管靶向疗法。PH的靶向治疗包括前列环素类似物、内皮素受体拮抗剂和5型磷酸二酯酶抑制剂；然而，这些治疗方法无法逆转肺血管重塑。最近，许多涉及他汀类药物等药物的新型治疗选择不断涌现。在本综述中，我们试图总结目前关于他汀类药物在PH治疗中的作用及其潜在临床效果的知识。许多基础研究已证明，他汀类药物在临床和实验模型中都有助于治疗PH。他汀类药物发挥作用的主要机制包括恢复内皮功能、减轻肺血管重塑、调节基因表达、调节参与PH的细胞内信号传导过程、抗炎反应以及与其他靶向药物协同作用。尽管如此，临床研究，尤其是针对PH的随机对照试验很少。目前的临床研究对他汀类药物在PH患者中的临床效果显示出相互矛盾的结果。需要精心设计的随机对照试验来测试他汀类药物治疗PH的安全性和有效性。
