目的 探討辛伐他汀對COPD 急性加重期( AECOPD) 患者誘導(dǎo)痰血管內(nèi)皮生長因子( VEGF) 水平和肺功能的影響。方法 選擇2007 年5 月至2008 年11 月住院的58 例AECOPD 患者,隨機(jī)分常規(guī)組( 30 例) 和他汀組( 28 例) 。常規(guī)組按照診療常規(guī)予以AECOPD 常規(guī)治療, 他汀組在常規(guī)治療基礎(chǔ)上加用辛伐他汀治療。兩組均于入院第1 d 和治療1 周后行肺功能檢查, 并收集誘導(dǎo)痰,采用ELIAS方法測定血清和誘導(dǎo)痰上清VEGF 的含量。結(jié)果 治療前兩組肺功能( FEV1% pred 和FEV1 /FVC) 、誘導(dǎo)痰VEGF水平無顯著差異( P gt; 0. 05) 。常規(guī)組治療1 周后與治療前比各項指標(biāo)無明顯變化( P gt;0. 05) 。他汀組治療1 周后FEV1% pred 和FEV1 /FVC 均較治療前顯著升高( P 均 lt;0. 01) , 且顯著高于常規(guī)組( P 均 lt;0. 01) ; 誘導(dǎo)痰VEGF 的水平較治療前及常規(guī)組顯著升高( P 均 lt;0. 05) , 但血清VEGF 的水平兩組及兩組治療前后無顯著差異( P 均 lt; 0. 05) 。治療1 周后誘導(dǎo)痰VEGF水平與FEV1% pred 和FEV1 /FVC 呈正相關(guān)( r = 0. 430, P lt; 0. 05; r = 0. 388, P lt; 0. 05) 。結(jié)論 辛伐他汀可改善AECOPD 患者肺功能, 并提高AECOPD患者誘導(dǎo)痰VEGF 的水平。肺功能的改善可能與肺內(nèi)VEGF水平的恢復(fù)有關(guān)。
引用本文： 夏書月,康健,何巍,許曉陽,何曉琳,王實. 辛伐他汀對COPD 急性加重期患者誘導(dǎo)痰血管內(nèi)皮生長因子水平和肺功能的影響. 中國呼吸與危重監(jiān)護(hù)雜志, 2010, 9(3): 295-297. doi: 復(fù)制
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- 1. Mannnino DM, Davis KJ. Lung function decline and outcomes in an elderly populine. Thorax, 2006, 61 : 472-477.
- 2. 劉春濤, 馮玉麟. 慢性阻塞性肺疾病急性加重期研究進(jìn)展. 中國呼吸與危重監(jiān)護(hù)雜志, 2007, 6: 413-415.
- 3. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastation in men with hypercholesterolemia. West of Scotland Coronary Prevention Group. N Engl J Med, 1995, 333 :1301-1307.
- 4. 中華醫(yī)學(xué)會呼吸病學(xué)分會慢性阻塞性肺疾病. 慢性阻塞性肺疾病診療指南( 2007 年修訂版) . 中華結(jié)核和呼吸雜志, 2007, 30 :8-17.
- 5. Cosio Piqueras MG, Cosio MG. Disease of the airway in chronic obstruction pulmonary disease . Eur Respir J, 2001, 18 Suppl : 41S-49S.
- 6. Kanazawa H. Role of vascular endothelial growth factor in the pathogenesis of chronic obstructive pulmonary disease. Med Sci Monit , 2007, 13 : RA189-195.
- 7. KasaharaY, Tuder RM, Cool CD, et al. Endothelial cell death and decreased expression of vascular endothelial growth factor and vascular endothelial growthfactor receptor 2 in emphysema. Am J Respir Crit Care Med, 2001, 163: 737-744 .
- 8. 崔吉香, 夏書月, 畢英, 等. 支氣管哮喘和慢性阻塞性肺疾病患者誘導(dǎo)痰中血管內(nèi)皮生長因子的變化. 中華結(jié)核和呼吸雜志,2008, 31: 307.
- 9. 王悅虹, 白春學(xué), 毛羽, 等. 血管內(nèi)皮生長因子及其受體在肺氣腫患者肺組織中的表達(dá). 中華內(nèi)科雜志, 2005 , 44: 276-279.
- 10. Takahashi S, Nakamurea H, Seki M, et al. Reversal of elastase -induced pulmonary emphysema and promotion of alveolar epithelial cell proliferation by simvastatin in mice. AmJ Physiol Lung Cell Mol Physiol, 2008 , 294: L882-L890 .
- 11. Keddissi JI, Younis WG, Chbeir EA, et al. The use of Statins and lung function in current and former smokers. Chest, 2007 , 132 :1764-1771.
- 12. Alexeeff SE, Litonjua AA, Sparrow D, et al . Statin use reduces decline in lung function: VA Nomative Aging Study. Am J Respir Crit Care Med, 2007, 176: 742-747.