他汀类药物对乙型肝炎肝硬化患者门静脉高压的临床疗效

肝脏 ›› 2019, Vol. 24 ›› Issue (1): 86-89.

他汀类药物对乙型肝炎肝硬化患者门静脉高压的临床疗效

徐湖波, 雷珍, 陈友平

431700 湖北天门市第一人民医院

收稿日期:2018-07-20 出版日期:2019-01-31 发布日期:2020-04-09
通讯作者: 陈友平

Received:2018-07-20 Online:2019-01-31 Published:2020-04-09

摘要/Abstract

摘要： 目的探讨他汀类药物对乙型肝炎肝硬化患者门静脉高压的临床疗效。方法收集2014年9月至2017年8月我院住院治疗的乙型肝炎肝硬化患者58例,随机分为辛伐他汀组(n=27)及安慰剂组(n=31),进行病史采集、肝功能分级;分别采集两组患者入组当日,1月、3月、6月血生化、血常规、凝血指标数据;分别于入组当日,6月后行DSA下HVPG测量。比较两组患者各生化指标及HVPG变化。结果辛伐他汀组患者1月、3月、6月时复查血胆固醇水平、血甘油三酯水平较入组时基线均明显降低,其余生化指标无明显变化。辛伐他汀组患者6月时复查HVPG较入组时显著降低,差异具有统计学意义(P<0.05)。辛伐他汀组患者6月时复查HVPG较安慰剂组患者在6月时复查HVPG降低,且差异具有统计学意义(P<0.05)。结论长期规律应用他汀类药物对乙型肝炎肝硬化患者门静脉高压具有明显的改善效果,对临床治疗有重要的指导意义。

关键词: 他汀类药物, 乙型肝炎肝硬化, 门静脉高压, 肝静脉压力梯度

徐湖波, 雷珍, 陈友平. 他汀类药物对乙型肝炎肝硬化患者门静脉高压的临床疗效[J]. 肝脏, 2019, 24(1): 86-89.

参考文献

[1] Abraldes JG, Tarantino I, Turnes J, et al. Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis. Hepatology, 2003,37:902-908.
[2] Abraldes JG, Albillos A, Ba±Ares R, et al. Simvastatin lowers portal pressure in patients with cirrhosis and portal hypertension: a randomized controlled trial. Gastroenterology,2009,136:1651-1658.
[3] 中华医学会肝病学分会. 慢性乙型肝炎防治指南2010年更新版. 中华实验和临床感染病杂志(电子版),2011,05:50-60.
[4] 中华医学会消化病学分会. 中国肝性脑病诊治共识意见(2013年,重庆) . 中国医学前沿杂志(电子版),2014,6:81-93.
[5] Bosch J, Garciapagán JC, Berzigotti A, et al. Measurement of portal pressure and its role in the management of chronic liver disease. Semin Liver Dis, 2006, 26:348-362.
[6] Amarenco P, Labreuche J. Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol,2009,8:453-463.
[7] Singh S, Singh PP, Singh AG, et al. Statins are associated with a reduced risk of hepatocellular cancer: a systematic review and meta-analysis. Gastroenterology,2013,144:323-332.
[8] Chae YK, Yousaf M, Malecek MK, et al. Statins as anti-cancer therapy; Can we translate preclinical and epidemiologic data into clinical benefit Discov Med, 2015,20:413.
[9] Graupera M, Zafra C, García H. Simvastatin treatment improves liver sinusoidal endothelial dysfunction in CCl cirrhotic rats. J Hepatol, 2007,46:1040-1046.
[10] Trebicka J, Hennenberg M, Laleman W, et al. Atorvastatin lowers portal pressure in cirrhotic rats by inhibition of RhoA/Rho-kinase and activation of endothelial nitric oxide synthase. Hepatology, 2007,46:242.
[11] Marrone G, Russo L, Rosado E, et al. The transcription factor KLF2 mediates hepatic endothelial protection and paracrine endothelial-stellate cell deactivation induced by statins. J Hepatol,2013,58:98.
[12] Russo MW, Hoofnagle JH, Gu J, et al. Spectrum of statin hepatotoxicity: experience of the drug-induced liver injury network. Hepatology, 2014,60:679-686.