Effect of atorvastatin on plasma level of interleukin 6 and tumor necrosis factor α in chronic pulmonary heart disease / 中国综合临床

ABSTRACT

Objective To explore the effect and mechanism of atorvastatin on pulmonary hypertension (PAH) in chronic pulmonary heart disease.Methods Seventy eight patients with chronic pulmonary heart disease were randomly signed into treating group and observing group.Forty healthy people were picked up from people taking physical examination at the same stage as control group.Patients in observing group were given routine treatment,and patients in treating group were given atorvastatin (20 mg/d) supplement beside routine treatment.Pulmonary function,ultrasound cardiogram,plasma interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured before and after 24 weeks of treatment.Results There were no difference in terms of forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FVC),pulmonary arterial pressure (PAP) and the levels of IL-6 and TNF-α between the observing group and treating group before treatment(P ＞ 0.05).While there were significant difference in terms of the serum levels of IL-6,TNF-α and PAP of treating group,observing group and normal control group at before treatment (IL-6(106.61 ± 31.34) ng/L,(105.33 ± 30.16) ng/L,(73.81 ± 31.12) ng/L,F =67.17 ; TNF-α(19.41 ± 10.21) ng/L,(18.25 ± 11.37) ng/L,(14.82 ± 4.33) ng/L,F =15.43 ; PAP(58.33 ± 8.95) mmHg,(56.04 ± 8.57) mmHg,(15.88 ±7.01) mmHg,F =88.78;P =0.00),and these levels in observing and treating group were higher than those in normal control group(P ＜0.01).After 24 weeks treatment,the IL-6,TNF-α,PAP in the treating group were (73.90 ± 27.12) ng/L,(14.91 ± 5.35) ng/L and (45.96 ± 5.61) mmHg respectively,significantly lower than those in observing group ((103.00 ± 28.12) ng/L,(17.22 ± 7.17) ng/L and (53.11 ± 9.21) mmHg respectively; P =0.025,0.045 and 0.031 respectively).The pulmonary function indexes including FEV1 and FEV1/FVC in treating group were much better than those in observing group at 24 weeks treatment (FEV1(57.85±10.31)％ vs.(43.9±31.33)％;FEV1/FVC(57.83±10.38)％ vs.(47.97± 14.79) ％ ;P =0.001,0.024 respectively).Conclusion Atorvastatin can effectively improve the life quality and pulmonary function,decrease PAP of patients with chronic pulmonary heart disease,and the mechanism may be related to the inhibition of inflammation in pulmonary vessels.