In Vivo Confirmation of the Role of Statins in Reducing Nitric Oxide and C-Reactive Protein Levels in Peripheral Arterial Disease
In Vivo Confirmation of the Role of Statins in Reducing Nitric Oxide and C-Reactive Protein Levels in Peripheral Arterial Disease
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DOI：
10.1016/j.ejvs.2008.12.009
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发表时间：
2009-04-01
影响因子：
5.7
通讯作者：
Acin Garcia, F.
中科院分区：
文献类型：
--
作者：
Martinez Aguilar, E.;De Haro Miralles, J.;Acin Garcia, F.
目的：炎症和其他介导内皮功能受损的过程在外周动脉疾病(PAD)的早期阶段发挥作用，其中C-反应蛋白(CRP)和血浆亚硝酸盐水平升高。我们的目的是分析他汀类药物对PAD患者血浆亚硝酸盐和C反应蛋白水平的影响。材料和方法：对30例PAD方丹II期患者进行前瞻性研究，测定其高敏C反应蛋白(hs-CRP)和血脂谱。结果：他汀类药物治疗后血浆亚硝酸盐水平显著降低(11.88±7.8mU/M vs.5.7+/-1.8mU/M，P=0.0001)。当患者按跛行阶段分层时，亚硝酸盐水平显著降低，无论是在Pad Fontaine分期IIA(9.5+/-3.3Mvs.5.3+/-1.7mM，P=0.0001)和在PAD Fontaine分期IIB(16.6+/-11.6Mvs.6.7+/-1.8MU，P=0.0001)，结论：他汀类药物治疗可降低PAD患者血浆亚硝酸盐和C反应蛋白水平。我们的数据支持他汀类药物在体内对体外培养的内皮细胞的影响，这表明他汀类药物通过作用于引发疾病的初始过程，减少氧化应激(随着过氧亚硝酸盐水平的下降，一氧化氮的生物利用度增加)，并抑制使疾病永久化的炎症过程，从而产生有益的影响。(C)2008年欧洲血管外科学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: Inflammatory and other processes mediating impairment of endothelial function, where there are increased levels of C-reactive protein (CRP) and plasma nitrites, have a part to play in the early stages of peripheral arterial disease (PAD). Our objective was to analyse the effect of statins on the plasma nitrite and CRP levels in PAD.Material and methods: A prospective study of 30 patients with PAD Fontaine stage II, with no prior treatment with statins, determined high sensitivity (hs)-CRP and lipid profile in the patients. Plasma nitrite levels were determined by colourimetric assay based on the Griess reaction, at baseline and after 1 month of treatment with atorvastatin 40 mg day(-1).Results: A significant reduction in plasma nitrite levels was detected after the treatment with statins (11.88 +/- 7.8 mu M vs. 5.7 +/- 1.8 mu M, p = 0.0001). There was also a significant reduction in hs-CRP levels (13.58 +/- 24.00 vs. 3.93 +/- 3.19, p = 0.02).When the patients were stratified according to claudication stage, a significant reduction in nitrite levels was obtained, both in patients with PAD Fontaine stage IIA (9.5 +/- 3.3 mu M vs. 5.3 +/- 1.7 mu M, p = 0.0001) and in stage IIB (16.6 +/- 11.6 mu M vs. 6.7 +/- 1.8 mu M, p = 0.032).Conclusions: Treatment with statins lowers plasma nitrite and CRP levels in patients with PAD. Our data support the effects of statins in vivo that have been demonstrated on the endothelium ex vivo, suggesting a beneficial effect by acting on the initial processes that trigger the disease, reducing oxidative stress (increase in the bioavailability of nitric oxide as peroxynitrite levels decrease) and curtailing the inflammatory processes which perpetuate the disease. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.