Balaguer Catalina, Peralta Alejandro, Ríos Ángel, Iglesias Amanda, Valera Josep Lluís, Noguera Aina, Soriano Joan B, Agustí Àlvar, Sala-Llinas Ernest
Servei de Pneumologia, Hospital Universitari Son Dureta/Son Espases, Palma de Mallorca, Spain.
Institut de Investigació Sanitària de Palma, Fundació d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain.
Contemp Clin Trials Commun. 2016 Jan 14;2:91-96. doi: 10.1016/j.conctc.2015.12.008. eCollection 2016 Apr 15.
Statins may have pleiotropic effects in COPD, but mechanisms remain unclear.
To assess the pleiotropic effect of statins in patients with stable COPD on (): lung function (); pulmonary and systemic inflammation (); endothelial function (vascular stiffness) and circulating vascular growth factors; and (), serum uric acid levels.
Pilot, double-blind, randomized, placebo-controlled clinical trial in 24 patients with stable COPD, all statin-naïve, who were randomized (1:1) to receive simvastatin 40 mg/24 h during 12 weeks (n = 12; 69.0 ± 7.3 years; post-bd FEV 53.4 ± 10.0% pred.) or placebo (n = 12; 66.4 ± 4.6 years; post-bd FEV 48.2 ± 12.6% pred.). Nine patients per group (total n = 18) completed the study.
Lung function, pulmonary and systemic inflammatory markers and the degree of vascular stiffness did not change significantly in any group. However, treatment with simvastatin increased the plasma levels of erythropoietin (Epo) (4.2 ± 2.2 mIU/mL to 6.8 ± 3.2 mlU/mL, p < 0.05) and reduced those of serum uric acid (7.1 ± 1.3 mg/dL to 6.5 ± 1.4 mg/dL, p < 0.01).
Short-term treatment with simvastatin in stable COPD patients did not modify lung function, pulmonary and systemic inflammation, or vascular stiffness, but it changed Epo and uric acid levels.
他汀类药物可能对慢性阻塞性肺疾病(COPD)具有多效性作用,但其机制仍不清楚。
评估他汀类药物对稳定期COPD患者的多效性作用,包括:()肺功能;()肺部和全身炎症;()内皮功能(血管硬度)和循环血管生长因子;以及()血清尿酸水平。
对24例稳定期COPD患者进行先导性、双盲、随机、安慰剂对照临床试验,所有患者均未服用过他汀类药物,将其随机(1:1)分为两组,一组在12周内接受辛伐他汀40mg/24小时治疗(n = 12;69.0±7.3岁;支气管舒张后FEV为预计值的53.4±10.0%),另一组接受安慰剂治疗(n = 12;66.4±4.6岁;支气管舒张后FEV为预计值的48.2±12.6%)。每组9例患者(共18例)完成了研究。
任何一组的肺功能、肺部和全身炎症标志物以及血管硬度程度均无显著变化。然而,辛伐他汀治疗可使促红细胞生成素(Epo)的血浆水平升高(从4.2±2.2mIU/mL升至6.8±3.2mlU/mL,p < 0.05),并使血清尿酸水平降低(从7.1±1.3mg/dL降至6.5±1.4mg/dL,p < 0.01)。
在稳定期COPD患者中,短期使用辛伐他汀治疗并未改变肺功能、肺部和全身炎症或血管硬度,但改变了Epo和尿酸水平。