阿托伐他汀钙片和血脂康片治疗冠心病合并高脂血症的效果对比分析

目的：分析比较阿托伐他汀钙片和血脂康片治疗冠心病合并高脂血症的临床效果。方法选取66例冠心病合并高脂血症患者为研究对象,随机分为两组,各33例。观察组患者给予阿托伐他汀钙片治疗,对照组患者给予血脂康片治疗。结果两组患者治疗前血脂各项指标差异均无统计学意义;治疗后两组甘油三酯（TG）均无明显变化（ P ＞0．05）;治疗后两组总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）均较治疗前降低（ P ＜0．05）,两组高密度脂蛋白胆固醇（HDL-C）均较治疗前升高（ P ＜0．05）;治疗后观察组TC、LDL-C和HDL-C指标变化均优于对照组（ P ＜0．05或P ＜0．01）。结论阿托伐他汀钙片治疗冠心病合并高脂血症的疗效确切,能够使TC和LDL-C下降,HDL-C升高,值得临床推广应用。     

Effects of Xuezhikang Capsule(血脂康胶囊) on Blood Lipids,Platelet Activation and Coagulation-Fibrinolysis Activity in Patients with Hyperlipidemia

Objective: To investigate the effects of Xuezhikang capsule (XZK, 血脂康胶囊) on blood lipids level, platelet activation and coagulation-fibrinolysis activity in patients with hyerlipidemia. Methods:Seventy-six patients of hyperlipidemia were randomly divided into two groups, the XZK group (n = 38) treated with XZK 600mg, taken two times per day and the Simvastatin (SIM) group (n = 38) treated with SIM 20mg per day, with the treatment lasting 8 weeks for both groups. Levels of fasting serum lipids, including total cholesterol (TC), triglyceride (TG), high and low density l ipoprotein cholesterol (HDL-C and LDL-C),plasma GMP-140, fibrinogen (FIB), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAl-) and prothrombin time (PT) were all measured before and 8 weeks after treatment. Data were compared before and after treatment and also compared with those measured in 20 healthy subjects of control. Results: Before treantment the levels of TC, TG and LDL-C were obviously higher and HDL-C level was significantly lower in hyperlipidemia patients than those in healthy subjects ( P＜0.05 or P＜0.01). After 4-8 weeks of XZK treatment, the levels of TC, TG, LDL-C and FIB and activities of GMP-140 and PAl-1 were obviously lowered (P＜0.05 or P＜0.01). But in the SIM group there was no obvious change in FIB (P＞0.05), instead it showed obvious increase of HDL-C and decrease of TC and LDL-C after treatment ( P＜0.05 or P＜0.01). Conclusion: XZK could inhibit platelet activity and improve coagulation-fibrinolysis function, besides its lipids lowering effect.     

血脂康对高脂血症患者胰岛素抵抗的影响

目的探讨血脂康对高脂血症患者胰岛素抵抗的影响。方法42例高脂血症患者采用HOMA模型计算胰岛素抵抗指数,根据是否伴有胰岛素抵抗分两组,即伴胰岛素抵抗的IR组18例和不伴胰岛素抵抗的NIR组24例。所有患者服用血脂康6周,观察治疗前后血脂、FPS、FINS、Homa-IR的变化。结果治疗后两组TC、TG、LDL-C、TC/HDL-C均显著下降(P<0·001),HDL-C有所升高,差异无显著性(P>0·005);IR组FPS有所下降,但差异无显著性(P>0·005),FINS、Homa-IR明显下降(P<0·005),而NIR组FPS、FINS、IR均无明显变化。结论血脂康对高脂血症患者不仅有调脂作用,同时还可改善伴胰岛素抵抗患者的胰岛素抵抗。     

Effects of Xuezhikang capsule on blood lipids, platelet activation and coagulation-fibrinolysis activity in patients with hyperlipidemia

Objective: To investigate the effects of Xuezhikang capsule (XZK) on blood lipids level, platelet activation and coagulation-fibrinolysis activity in patients with hyerlipidemia.Methods: Seventy-six patients of hyperlipidemia were randomly divided into two groups, the XZK group (n = 38) treated with XZK 600mg, taken two times per day and the Simvastatin (SIM) group (n = 38) treated with SIM 20mg per day, with the treatment lasting 8 weeks for both groups. Levels of fasting serum lipids, including total cholesterol (TC), triglyceride (TG), high and low density lipoprotein cholesterol (HDL-C and LDL-C), plasma GMP-140, fibrinogen (FIB), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-) and prothrombin time (PT) were all measured before and 8 weeks after treatment. Data were compared before and after treatment and also compared with those measured in 20 healthy subjects of control.Results: Before treantment the levels of TC, TG and LDL-C were obviously higher and HDL-C level was significantly lower in hyperlipidemia patients than those in healthy subjects (P<0.05 orP<0.01). After 4–8 weeks of XZK treatment, the levels of TC, TG, LDL-C and FIB and activities of GMP-140 and PAI-1 were obviously lowered (P<0.05 orP<0.01). But in the SIM group there was no obvious change in FIB (P>0.05), instead it showed obvious increase of HDL-C and decrease of TC and LDL-C after treatment (P<0.05 orP<0.01).Conclusion: XZK could inhibit platelet activity and improve coagulation-fibrinolysis function, besides its lipids lowering effect.     

Short-andLong-Term Effects of Xuezhikang(血脂康),An Extract of Cholestin,on Serum Proprotein Convertase Subtilisin/Kexin Type 9 Levels

Objective:To investigate the short- and long-term effects of Xuezhikang(血脂康,XZK),an extract of Cholestin,on proprotein convertase subtilisin/kexin type 9(PCSK9) level.Methods:Thirty rats were randomly divided into three groups and were given saline,XZK 1,200 mg/kg or lovastatin 10 mg/kg respectively by daily gavage for 3 days(n=10 for each).Sixteen patients without previous iipid-lowering drug treatment for dyslipidemia received XZK 1,200 mg daily for 8 weeks.Fasting blood samples and liver tissue were collected at day 3 for rats,while the blood samples were obtained at baseline and week 8 from patients.The serum PCSK9 and lipid profile were measured.The expression of hepatic low density lipoprotein(LDL) receptor and sterol regulatory element binding protein 2(SREBP-2) were measured by real time-PCR.Results:PCSK9 levels in rats were significantly increased in the XZK and lovastatin groups(P=0.002,P=0.003 vs.control) at day 3,while no significant differences were found in the levels of lipid parameters.PCSK9 levels in patients increased by34%(P=0.006 vs.baseline) accompanied by total cholesterol and LDL-cholesterol decreased by 22%and 28%(P=0.001,P=0.002 vs.baseline).The hepatic mRNA levels of LDL-receptor and SREBP-2 were significantly increased in the XZK and lovastatin groups.Conclusion:XZK has significant impact on PCSK9 in a short- and long-term manner in both rats and humans.Moreover,the data indicated that as lovastatin,XZK increased PCSK9 levels through SREBP-2 pathway.     

血脂康对介入术后冠心病合并高血脂患者预后的影响

目的:观察血脂康治疗冠心病介入术后合并高血脂患者心功能预后,并观察其对血脂和血浆FIB水平的影响。方法:选取2015—2016年在顺义区医院诊治的冠心病介入治疗术后合并高脂血症患者80例。随机分为对照组和观察组,每组40例。2组患者均予一般基础治疗,对照组予阿托伐他汀钙治疗,观察组在对照组基础上加以服用血脂康治疗,均治疗4周。治疗前后分别检测血脂、血浆FIB、PAI-1、t-PA水平,并于治疗前后及随访3个月后进行心功能评定。结果:治疗后,1)2组患者TG、TCHO、HDL-C、LDL-C均较治疗前减低(P0.05),且观察组各项指标的改善程度明显优于对照组(P0.05);2)2组的血浆Fib、PAI-1治疗后均降低,t-PA值增高(P0.05),且观察组明显优于对照组(P0.05);3)治疗后2组患者心功能都得到明显改善,观察组优于对照组(P0.05),且3个月随访后其各项指标均优于对照组(P0.05)。结论:血脂康可以降低冠心病合并高脂血症患者的血脂水平,改善其血液凝聚度,并可明显提高其心功能预后水平。     

血脂康对老年高血脂血症患者血管内皮功能的影响

目的　观察血脂康对老年高脂血症患者血管内皮功能的影响。方法　 6 5例老年高脂血症患者随机分为治疗组(血脂康 ) 35例 ,对照组 (普拉固组 ) 30例 ,治疗组予服血脂康胶囊 0 6 ,2次 /天 ,对照组予服普拉固片 10mg ,1次 /晚 ,连用 8周 ,治疗前后测定两组TG、TC、HLD -C及ET水平。结果　两组治疗前TG、TC、HLD -C及ET水平相似 (P >0 0 5 ) ,治疗后血脂康与普拉固一样具有降低高脂血症患者的TG、TC、HLD -C、ET水平并升高HLD -C ,与治疗前比较差异显著 (P <0 0 5 )。结论　血脂康可以降低老年高脂血症患者的血脂异常 ,并明显改善患者的血管内皮功能。     

血脂康胶囊中的一个新莫纳克林类似物(英文)

血脂康胶囊(红曲醇提取物)是北京北大维信生物科技有限公司自主研究的特制红曲霉发酵制成的调脂中药。通过血脂康调整血脂的临床观察,发现血脂康可降低各种冠心病相关事件的危险性及各种死亡率。为了解释血脂康的许多临床表现,对血脂康进行系统的成分研究。通过成分分析研究,从血脂康中分离纯化了一个新的莫纳克林类化合物,命名为α,β-dehydromonacolin L(1)及两个已知的莫纳克类化合物monacolin L(2)和3-(2,6-dimethyl-1,2,4a,5,6,7,8,8a-octahydronaphthalen-1-yl)propanoic acid(3)。结合核磁共振和质谱分析确定了化合物的化学结构。     

血脂康治疗糖尿病肾病的系统评价

目的系统评价血脂康治疗糖尿病肾病（DKD）的疗效和安全性。方法计算机检索Cochrane图书馆临床对照试验资料库（2008年第3期）、MEDLINE（1980～2008．9）、EMbase（1980～2008．9）、CBMdisc（1990～2008．9）、CNKI（1994～2008．9）,手工检索相关文献,按纳入与排除标准选择试验、评价质量,提取资料,并用RevMan 4．2软件对数据进行Meta分析。结果共纳入血脂康治疗糖尿病肾病的9个RCT,8个RCT的方法学质量评价为B级,另1个为C级。Meta分析结果显示：血脂康组在降低DKD患者24h尿蛋白[WMD=-0．87,95％CI（-1．34,-0．41）]、尿微量白蛋白[WMD=-115．39,95％CI（-127．63,-103．15）]及尿蛋白排泄率方面[WMD=-65．46,95％CI（-68．87,-62．12）]均优于常规治疗组;血脂康组在改善DKD患者Scr水平方面[WMD=-5．42,95％CI（-11．06,0．21）]与常规治疗组相似;血脂康组在降低TC[WMD=-1．71,95％CI（-2．39,-1．03）]、TG[WMD=-0．96,95％CI（-1．46,-0．46）]、LDL-C[WMD=-1．01,95％CI（-1．64,-0．38）]以及升高HDL-C[WMD=0．22,95％CI（0．09,0．36）]方面均优于常规治疗组;血脂康在改善FBS方面[WMD=-0．01,95％CI（-0．49,0．47）]与常规治疗组相当,但在改善2h-Bs[WMD=-1．10,95％CI（-1．35,-0．85]、HbA1c方面[WMD=-0．41,95％CI（-0．56,-0．27）]优于常规治疗组。血脂康未见明显不良反应或过敏反应的报道。结论现有的临床证据显示,血脂康能够降低24h尿蛋白、尿微量白蛋白及尿蛋白排泄率,且能调节血脂（降低TC、TG、LDL-C和升高HDL-C）和控制血糖（降低2h-BS和HbA1c）。但由于纳入研究存在选择性偏倚和测量性偏倚的中度可能性,势必影响结果的论证强度,期待更多高质量的随机双盲对照试验提供高质量的证据。     

中药血脂康调脂治疗的临床观察

目的观察老年人冠心病合并血脂异常患者口服血脂康胶囊降脂作用的临床疗效。方法120例年龄在62—75岁的老年患者,诊断为冠心病并血脂异常,随机分成两组,每组60例。均采用硝酸异山梨酯注射液＋5％葡萄糖250ml静滴,2;L／d,10％氯化钾7ml、普通胰岛素3u＋5％葡萄糖250ml静滴,1础d,连续14d为1疗程。间隔7d后,再行第2疗程,共3个疗程。治疗组加服血脂康胶囊,2影次,2次／d,连服8周。结果血脂康可明显降低低密度脂蛋白胆固醇（LDL—c）、血清总胆固醇（TC）、三酰甘油（TG）水平,升高高密度脂蛋白胆固醇（HDL—c）（P〈0．01）,差异具有高度显著性。结论血脂康有明显的调脂作用,老年高脂血症患者获益大,安全可靠,值得推广应用。