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目的:探讨辛伐他汀对慢性肺源性心脏病(肺心病)肺动脉高压的影响及其机制。方法:将60例肺心病慢性缓解期患者随机分为对照组(30例)和治疗组(30例),选取同期进行体检的健康人30例作为正常组。对照组给予抗感染、吸氧等一般常规治疗,治疗组在常规治疗的基础上加用辛伐他汀,测定治疗前后的三尖瓣区最大反流速度,计算收缩期肺动脉压(PAPs);测定治疗前后高敏感C反应蛋白(hs-CRP)含量的变化。结果:对照组、治疗组血清中的hs-CRP含量及PAPs治疗前明显高于正常组(P<0.01),治疗组与对照组治疗后hs-CRP,PAPs均较治疗前明显降低,治疗组降低数值大于对照治疗组(P<0.05)。结论:加用辛伐他汀治疗较常规治疗更有助于肺心病患者肺动脉高压的降低并能使hs-CRP含量的下降。辛伐他汀缓解肺动脉高压可能与抑制肺血管炎性反应有关。
Objective: To investigate the effect of simvastatin on pulmonary hypertension in patients with chronic cor pulmonale (pulmonary heart disease) and its mechanism. Methods: Sixty patients with chronic remission of pulmonary heart disease were randomly divided into control group (30 cases) and treatment group (30 cases). 30 healthy subjects were selected as normal group. The control group was given conventional therapy such as anti-infective and oxygen inhalation. The treatment group was given simvastatin on the basis of routine treatment, and the maximum reflux velocity in the tricuspid valve area before and after treatment was measured to calculate the systolic pulmonary artery pressure (PAPs) Changes of high sensitive C reactive protein (hs-CRP) before and after treatment. Results: The levels of hs-CRP and PAPs in the control group and the treated group were significantly higher than those in the normal group (P <0.01). The hs-CRP and PAPs of the treatment group and the control group were significantly lower than those before treatment The reduction value was larger than that of the control group (P <0.05). Conclusion: Compared with routine treatment, simvastatin plus hypoglycemic treatment is more effective in reducing pulmonary hypertension and decreasing hs-CRP in patients with pulmonary heart disease. Simvastatin to relieve pulmonary hypertension may be related to the inhibition of pulmonary vascular inflammatory response.