Jin Yu, Qiu Chunguang, Zheng Qiangsun, Liu Ling, Liu Zhiqiang, Wang Yi
Yu Jin, Department of Cardiology,Wuhan General Hospital of Guangzhou Military Command, Wuhan 430070, Hubei Province, China.
Chunguang Qiu, Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Pak J Med Sci. 2015 Jan-Feb;31(1):37-42. doi: 10.12669/pjms.311.5840.
To compare the efficacy of 40 mg and l0 mg atorvastatin on serum levels of 8-Hydroxy-Guanin (8-OHdG) and the cardiac function in patients with ischemic cardiomyopathy (ICM).
One hundred twenty three hospitalized ICM patients and 120 healthy controls were included in this study. All subjects were randomly divided into two groups: 10 mg/d atorvastatin group (n=62) and 40 mg/d atorvastatin group (n=61). Serum levels of C-reactive protein (CRP), creatine kinase, glutamic-pyruvic transaminase, lipids and B-type natriuretic peptide (BNP) were tested in all subjects both at the initial phase and the terminal phase of this study. Adverse drug reaction events were recorded in this study. Echocardiographic method was applied to compare the cardiac function before and after treatment in the double blind study. Serum 8-OHdG levels were tested by enzyme-linked immunosorbent assay (ELISA) before and after treatment, and the results in atorvastatin treatment groups were compared with the healthy controls.
Serum 8-OHdG levels in ICM patients were significantly higher than that in normal control groups (p<0.05). There was significant difference of Serum 8-OHdG levels in 40 mg/d atorvastatin group (p<0.05), but was no significant difference in 10 mg/d atorvastatin group before and after the treatment. The 8-OHdG level in 40 mg/d atorvastatin group was significantly lower than that in 10 mg/d atorvastatin group before the treatment as well as after the treatment (p<0.05). The systolic and diastolic function improved significantly in 40 mg/d atorvastatin group before and after treatment, as well as in comparison with 10 mg/d atorvastatin group (p<0.05).
Serum 8-OHdG possibly plays an important role in the pathogenesis of ICM. Atorvastatin is safe and effective in ICM treatment; furthermore atorvastatin which also has independent lipid lowering effect, is significantly better in the dose of 40 mg/day.
比较40mg和10mg阿托伐他汀对缺血性心肌病(ICM)患者血清8-羟基鸟嘌呤(8-OHdG)水平及心功能的影响。
本研究纳入123例住院ICM患者和120例健康对照者。所有受试者随机分为两组:10mg/d阿托伐他汀组(n=62)和40mg/d阿托伐他汀组(n=61)。在本研究的初始阶段和末期阶段,检测所有受试者的血清C反应蛋白(CRP)、肌酸激酶、谷丙转氨酶、血脂和B型利钠肽(BNP)水平。记录本研究中的药物不良反应事件。在双盲研究中,应用超声心动图方法比较治疗前后的心功能。治疗前后采用酶联免疫吸附测定(ELISA)检测血清8-OHdG水平,并将阿托伐他汀治疗组的结果与健康对照者进行比较。
ICM患者血清8-OHdG水平显著高于正常对照组(p<0.05)。40mg/d阿托伐他汀组血清8-OHdG水平有显著差异(p<0.05),但10mg/d阿托伐他汀组治疗前后无显著差异。40mg/d阿托伐他汀组治疗前及治疗后的8-OHdG水平均显著低于10mg/d阿托伐他汀组(p<0.05)。40mg/d阿托伐他汀组治疗前后的收缩和舒张功能均显著改善,与10mg/d阿托伐他汀组相比也有改善(p<0.05)。
血清8-OHdG可能在ICM发病机制中起重要作用。阿托伐他汀在ICM治疗中安全有效;此外,阿托伐他汀具有独立的降脂作用,40mg/天剂量的效果显著更好。