大剂量阿托伐他汀治疗冠心病并发高脂血症的有效性与安全性

目的比较阿托伐他汀80 mg/d与阿托伐他汀20 mg/d在冠心病并发高脂血症患者中调脂的疗效与安全性。方法将血脂未达标的84例冠心病患者随机分成两组。80 mg组:阿托伐他汀80 mg/d;20 mg组:阿托伐他汀20 mg/d。治疗前、治疗后4周、12周检查血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、谷丙转氨酶（ALT）、肌酸磷酸激酶（CK）。结果阿托伐他汀20 mg/d与80 mg/d均能显著降低TC（P<0.01）、LDL-C（P<0.01）,阿托伐他汀80 mg/d作用强于20 mg/d（P<0.05）。结论阿托伐他汀80 mg/d与20 mg/d均能显著降低TC、LDL-C水平,80 mg组明显优于20 mg组,两种剂量均有好的安全性。     

不同剂量的阿托伐他汀对缺血性心肌病患者心肌能量消耗的影响

目的分析不同剂量的阿托伐他汀对缺血性心肌病患者心肌能量消耗及左心室功能影响。方法选取90例缺血性心肌病患者,采取随机数字表法分为对照组与观察组,每组各45例,对照组给予10mg阿托伐他汀治疗,观察组给予40mg阿托伐他汀治疗,比较两组患者肌能量消耗及左心室功能变化、心血管事件及不良反应发生率。结果两组患者治疗后与治疗前比较左心室射血分数增加,左心室舒张末期内径缩小,左心室舒张末期容积缩小,左心室短轴缩短率增加,心搏量增加,静脉血N-末端脑钠肽前体水平降低,心肌能量消耗降低,且两组上述指标改善比较差异有统计学意义(P<0.05)。两组肌肉疼痛、肌炎、胃肠道症状、腔隙性脑梗死及心功能恶化的发生率比较差异无统计学意义(P>0.05)。结论 40mg的阿托伐他汀相比于10mg的阿托伐他汀治疗缺血性心肌病的疗效显著,可明显改善患者的心肌能量消耗与左心室功能,未增加心血管事件及不良反应发生率。     

不同剂量阿托伐他汀对急性冠状动脉综合征患者血清明胶酶B水平影响的观察

目的探讨急性冠状动脉综合征(ACS)患者住院早期,应用不同剂量阿托伐他汀后,血清明胶酶B(MMP-9)及基质金属蛋白酶组织抑制因子-1(TIMP-1)水平的变化。方法选择ACS患者82例,随机分为三组:阿托伐他汀10mg组30例,阿托伐他汀20mg组30例,阿托伐他汀40mg组22例,均于入院24h内开始给予阿托伐他汀治疗,测定三组入院时及治疗2周后血清MMP-9及TIMP1水平的变化。结果ACS患者早期应用阿托伐他汀可明显降低血清MMP-9水平,提高TIMP-1水平,阿托伐他汀20mg组及阿托伐他汀40mg组均优于阿托伐他汀10mg组,相比有显著性差异,阿托伐他汀40mg组优于阿托伐他汀20mg组,但相比无显著性差异。结论ACS患者早期应用阿托伐他汀可降低血清MMP-9水平,升高TIMP-1水平,阿托伐他汀20mg作用明显优于10mg,阿托伐他汀40mg与20mg相比,疗效无显著性差异。     

阿托伐他汀对不稳定性心绞痛患者介入治疗后血清hs-CRP的影响

目的研究不同剂量阿托伐他汀对不稳定性心绞痛患者经皮冠状动脉介入(PCI)治疗术后炎症因子、调脂疗效的影响。方法对80例不稳定心绞痛患者行冠状动脉介入术,随机分为阿托伐他汀10mg/d组(A组)和20mg/d组(B组)各40例,手术当天、术后24h、术后2周空腹采血,测定血清高敏C-反应蛋白(hs-CRP)和肌钙蛋白的Ⅰ(CTnI)浓度以及血脂水平。结果阿托伐他汀20mg组较10mg组PCI术后血清hs-CRP和CTnI浓度降低更明显(P<0.05)。两组术后血脂水平较术前略有降低,但无统计学意义(P>0.05)。结论冠脉介入术后患者血清hs-CRP和CTnI水平升高;阿托伐他汀能降低冠脉介入术后患者血清hs-CRP和CTnI水平;20mg阿托伐他汀治疗较10mg阿托伐他汀疗效更好。     

每日40 mg阿托伐他汀对预防2型糖尿病患者颈动脉硬化影响的观察

目的 观察40 mg/d阿托伐他汀对预防T2DM患者颈动脉硬化的影响. 方法 将T2DM合并颈动脉斑块患者随机分为给予40 mg/d阿托伐他汀治疗的观察（n=31）组和给予常规剂量阿托伐他汀治疗的对照（n=30）组,分别于治疗前和治疗后12周检测血脂指标、颈动脉斑块情况及内皮功能情况. 结果 观察组TG、TC、LDL-C、载脂蛋白B水平、颈动脉内=中膜厚度、血管内径和斑块面积均低于对照组（P＜0.05）;载脂蛋白A-I水平以及内皮依赖性血管舒张功能均高于对照组（P＜0.05）;两组HDL-C比较差异无统计学意义. 结论 40mg/d阿托伐他汀有助于改善血脂代谢水平、颈动脉斑块情况以及内皮舒张功能,对于预防T2DM患者颈动脉硬化有积极价值.     

阿托伐他汀对动脉粥样硬化患者血浆hs-CRP和血小板活化标志物CD62p的影响

目的研究阿托伐他汀对动脉粥样硬化患者血浆hs-CRP和血小板活化标志物CD62p的影响及机制的初步探讨。方法选择40例健康体检者为对照组,40例动脉粥样硬化患者为试验组,对动脉粥样硬化组给予阿托伐他汀20mg/d治疗4周,测定治疗前后hs-CRP及CD62p水平,并和正常组比较。结果动脉粥样硬化患者治疗前血浆hs-CRP、CD62p明显高于正常对照组(P<0.05),给予阿托伐他汀治疗后血浆hs-CRP、CD62p明显下降(P<0.05),同时肝功能谷丙转氨酶轻度升高,但无统计学意义(P>0.05)。结论阿托伐他汀对动脉粥样硬化患者具有独立于降脂作用之外的抗炎作用及减轻血小板的活化,其机制可能与减少脂质在血管内膜沉积,使得炎性细胞释放炎性因子减少和内皮细胞的损伤减轻有关,同时显示阿托伐他汀具有良好的安全性。     

不同剂量阿托伐他汀在不稳定型心绞痛患者的早期应用

目的:观察不稳定型心绞痛(UAP)患者使用2种剂量(10和20mg/d)的阿托伐他汀治疗10d后血脂、高敏C反应蛋白(hsCRP)、基质金属蛋白酶9(MMP9)、一氧化氮(NO)、肌酸激酶(CK)及谷丙转氨酶(ALT)的变化。方法:将临床确诊为UAP的90例患者随机分为:阿托伐他汀治疗组:分别接受10mg/d(32例)和20mg/d(30例)阿托伐他汀治疗;对照组(28例):不接受任何调脂药物治疗;所有对象均测定治疗前和治疗10d后hsCRP、MMP9、NO、ALT、CK和血脂水平的变化。结果:阿托伐他汀治疗组治疗前后比较,血脂、hsCRP、MMP9水平明显下降(P<0.05),与对照组治疗后相比亦明显下降(P<0.05);除hsCRP外,20mg/d较10mg/d治疗后血脂、MMP9水平下降更显著(P<0.05)。20mg/d治疗前后比较,ALT水平显著升高(P<0.05);治疗后2组ALT水平依次升高,且差异有统计学意义(P<0.05)。结论:在UAP早期使用较大剂量(20mg/d)的阿托伐他汀治疗10d,即可明显减轻炎症、调节血脂、稳定斑块。     

40mg对比10mg阿托伐他汀对ACS合并糖尿病患者糖代谢基因Akt／Glut4表达的影响

目的比较40mg和10mg阿托伐他汀对ACS合并糖尿病患者糖代谢基因Akt／Glut4的表达足否存在差异。方法80例ACS合并糖尿病患者随机分为阿托伐他汀40mg和10mg治疗组,于治疗前、治疗后1个月、3个月分别检测空腹血糖（FBG）、血脂等,并应用ELISA双抗体央心法测定血清中Akt／Glut4表达。结果阿托伐他汀10mg组,于治疗前、治疗后1个月及3个月AkI和Glut4表达水平筹异均尤统计学意义;40mg治疗组,治疗后3个月与治疗前比较,Akt和Glut4的表达均降低,有显著的统计学差异（P=0．008和P=0．033）。而对于FBG的影响：10rag组及40rag组治疗后3个月较治疗前有升高倾向,但差异无统计学意义（P值分别为0．852和0．650）。结论阿托伐他汀40mg的治疗剂量可以下调糖代谢基因Akt／Glut 4在ACS合并糖尿病患者中的表达。40mg阿托伐他汀对空腹血糖的影响不鼎著．。     

瑞舒伐他汀和阿托伐他汀对氯吡格雷抗血小板活性的影响

目的观察瑞舒伐他汀和阿托伐他汀对氯吡格雷抗血小板活性的影响。方法选择60例冠心病患者接受阿司匹林100mg/d、氯吡格雷75 mg/d及低分子肝素5000 U/12 h治疗,5 d后随机分为阿托伐他汀20mg/d(阿托伐他汀组,30例)和瑞舒伐他汀10 mg/d(瑞舒伐他汀组,30例)。在服用氯吡格雷之前(基线值)、加用他汀类药物之前及服用他汀类药物3d后,用全血阻抗法分别测定不同浓度二磷酸腺苷(5、10、20μmol/L)诱导的血小板聚集率。结果与基线值比较,服用氯吡格雷5 d后和加服他汀类药物治疗3 d后,2组患者血小板聚集率明显降低,差异有统计学意义(P<0.05);与治疗前比较,阿托伐他汀组患者血小板聚集率有所升高,而瑞舒伐他汀组患者血小板聚集率有所下降,但差异无统计学意义(P>0.05)。结论经细胞色素3A4途径代谢的阿托伐他汀及不经细胞色素3A4代谢的瑞舒伐他汀,短期内对氯吡格雷抗血小板活性无影响。     

不同剂量阿托伐他汀钙片对老年缺血性脑血管病患者影响的对比研究

目的比较不同剂量阿托伐他汀钙片对老年缺血性脑血管病患者的影响。方法选取2014年1月—2016年1月重庆市长寿区人民医院收治的老年缺血性脑血管病患者120例,采用随机数字表法随机分为对照组和试验组,每组60例。在常规治疗基础上,对照组患者给予小剂量阿托伐他汀钙片(20 mg/次),试验组患者给予大剂量阿托伐他汀钙片(40 mg/次);两组患者均连续治疗8周。比较两组患者治疗前后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、C反应蛋白(CRP)及同型半胱氨酸(Hcy)水平,观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者血清TC、TG、LDL及HDL水平比较,差异无统计学意义(P>0.05);治疗后试验组患者血清TC、TG、LDL水平低于对照组,血清HDL水平高于对照组(P<0.05)。治疗前两组患者血清CRP、Hcy水平比较,差异无统计学意义(P>0.05);治疗后试验组患者血清CRP、Hcy水平低于对照组(P<0.05)。治疗期间两组患者均未出现严重不良反应。结论与小剂量阿托伐他汀钙片(20 mg/次)相比,大剂量阿托伐他汀钙片(40 mg/次)能更有效地改善老年缺血性脑血管病患者血脂代谢,降低血清CRP及Hcy水平,且未增加不良反应发生风险。     

Preference for 2 mg versus 4 mg Nicotine Chewing Gum

Smokers attending a 4-week course of treatment at a Smokers Clinic were given free choice of 2 and 4 mg nicotine chewing gum. Data on gum use beyond the first week of treatment were obtained from 117 gum users. Of these 40.2% were using 2 mg gum only, 24.8% were using 4 mg gum only and 35.0% were using a combination of both. More 2 mg gum was used during the first week but there was no difference in the use of the two preparations during the last 3 weeks of treatment. Smokers clinic clients seem to accept the 4 mg gum well. The choice of the gum was not related to pre-treatment cigarette consumption, CO and blood nicotine levels, or to questionnaire measures of cigarette dependence. Subjects choosing 4 mg gum or a combination of 2 mg and 4 mg gum used significantly more pieces of gum per day than those using 2 mg gum only, and the nicotine content of their daily gum ration was almost three times higher. Five to 10 weeks after stopping smoking, subjects still using 2 mg gum showed a significant drop in blood nicotine concentration compared with smoking, while 4 mg gum users remained close to their smoking level. Possible reasons for individual differences in gum use are discussed.     

Ten mg dexrabeprazole daily is as effective as 20 mg dexrabeprazole daily

Ten mg dexrabeprazole daily has been shown to be more effective than 20 mg rabeprazole daily against gastroesophageal reflux disease （GERD）. This report shows that the efficacy of 10 mg dexrabeprazole daily is equivalent to that of 20 mg dexrabeprazole daily against GERD. This implies that a dose of 10 mg dexrabeprazole is sufficient to block the maximum amount of proton pumps without any need to double the dose as suggested with rabeprazole.     

Oral dexamethasone in the treatment of croup: 0.15 mg/kg versus 0.3 mg/kg versus 0.6 mg/kg

The objective of this study was to compare the efficacy of a single dose of oral dexamethasone of varying sizes in 120 children hospitalized with croup in two sequential double blind, randomized, controlled clinical trials (Trials A and B). The study was conducted in the Emergency Department Observation Ward of a tertiary pediatric hospital. One hundred and twenty children (age range 6 to 160 months) hospitalized with croup participated. Baseline characteristics for the two groups in each trial were similar. In Trial A 60 children received either 0.6 or 0.3 mg/kg dexamethasone syrup; in Trial B 60 children received either 0.3 or 0.15 mg/ kg dexamethasone syrup. Duration of hospitalization, reduction in croup scores, and adrenaline usage were evaluated. Median duration of hospitalization was similar for children in Trial A (7 and 8 hr), and in Trial B (9 and 9 hr). Croup scores following treatment did not differ and were significantly lower than initial scores for all groups and in each trial. Other outcome measures were similar for the two groups in each trial, including need for nebulized adrenaline, numbers of patients admitted to intensive care, rate of return to medical care with reoccurrence of croup, and readmission to hospital with croup following discharge from hospital. We conclude that oral dexamethasone in a dose of 0.15 mg/kg is as effective as 0.3 or 0.6 mg/kg in relieving symptoms and results in a similar duration of hospitalization in children with croup. Pediatr Pulmonol. 1995; 20:362–368 . © 1995 Wiley-Liss, Inc.     

Esomeprazole 40 mg provides improved intragastric acid control as compared with lansoprazole 30 mg and rabeprazole 20 mg in healthy volunteers

AIM: To compare the effects of standard-dose esomeprazole with those of standard doses of lansoprazole and rabeprazole on intragastric pH during repeated daily oral dosing in healthy volunteers. METHODS: In two standardized, randomized crossover studies, Helicobacter pylori negative healthy volunteers (study A: 19 males, 5 females; study B: 13 males, 10 females) received esomeprazole 40 mg and either lansoprazole 30 mg (study A) or rabeprazole 20 mg (study B) orally once daily in the morning for 5 days. Continuous 24-hour intragastric pH recording was performed on day 5. RESULTS: The intragastric pH was maintained >4 for 65% (95% CI 59.5-71.3) of the 24-hour period with esomeprazole and for 53% of the time (95% CI 47.0-58.9) with lansoprazole in study A (p < 0.001). In study B, the proportion of time with pH >4 was 61% (95% CI 53.6-68.3) with esomeprazole versus 45% (95% CI 37.7-52.5) with rabeprazole (p = 0.005). The 24-hour median pH and the proportion of volunteers with intragastric pH >4 for > or =12 h and > or =16 h were significantly higher with esomeprazole than with either lansoprazole or rabeprazole. CONCLUSION: Esomeprazole 40 mg provides significantly more effective and more sustained gastric acid control than lansoprazole 30 mg or rabeprazole 20 mg in healthy volunteers.     

Reduction of gastric acid secretion by 10 mg and 30 mg omeprazole once daily

The reduction in gastric acid secretion by 10 mg and 30 mg omeprazole was studied in 12 patients with ulcer disease in a randomized, double-blind, two-way balanced crossover study. A standardized pentagastrin test was performed before the study and 24 h after each treatment period of 6 days. Treatment was followed by a washout period of 7 days. Omeprazole, 30 mg/day, significantly reduced basal acid output (BAO) by 90% and pentagastrin-stimulated acid output (PAO) by 45% (p less than 0.01), whereas BAO and PAO were not significantly reduced by omeprazole, 10 mg/day.