瑞舒伐他汀对急性冠状动脉综合征患者介入后血管内皮功能、血清炎症因子和预后的影响

目的：研究瑞舒伐他汀（RSVT）对急性冠状动脉综合征（ACS）患者行经皮冠状动脉介入治疗术（PCI）后血管内皮功能（VEF）、血清炎症因子（IF）以及预后的影响。方法选择该院2010年7月至2013年7月80例行PCI术的ACS病患进行观察,分为观察组和对照组,每组40例。观察组给予RSVT干预治疗,对照组给予常规治疗。对比两组VEF、IF以及预后情况。结果观察组术后4周VWF为（92．6±12．3）％、ET‐1为（55．6±5．6）ng／L;较对照组术后4周的（105．4±13．6）％、（67．8±7．4）ng／L明显更低;观察组术后4周NO为（78．6±9．4）μmol／L,较对照组术后4周的（63．2±9．5）μmol／L明显更高。观察组PCI术后4周CRP为（5．4±2．2）mg／L,较对照组的（10．5±4．1）mg／L明显更低。观察组CVE发生率为5．00％（2／40）、再狭窄率为2．50％（1／40）明显较对照组的30．00％（12／40）、10．00％（4／40）更低,差异有统计学意义（均P＜0．05）。结论RSVT能够有效改善ACS病患PCI术后VEF,减少炎性反应,降低CVE以及再狭窄的发生概率。     

瑞舒伐他汀对大鼠缺血心肌嗜铬粒蛋白A和MR-proADM表达的影响

目的 研究瑞舒伐他汀对急性心肌梗死大鼠缺血心肌嗜铬粒蛋白A(CGA)和肾上腺髓质素原中间片段(MR-proADM)表达的影响.方法 采用冠状动脉结扎术建立30只急性心肌梗死大鼠模型,分成对照组(n=15)和治疗组(n=15),以15只正常大鼠作为空白组,其中治疗组接受瑞舒伐他汀治疗.分别在手术治疗后3、7d和14 d取5只大鼠的心肌组织.采用荧光定量PCR检测组织内CGA和MR-proADM mRNA转录量,采用Western blot检测组织内CGA和MR-proADM的表达量.结果 治疗后第7天和第14天治疗组CGA和MR-proADM mRNA和蛋白表达量与空白组差异无统计学意义(P＞0.05),对照组CGA和MR-proADM mRNA和蛋白表达量均显著高于治疗组和空白组(P＜0.05).结论 瑞舒伐他汀可有效降低急性心肌梗死大鼠心肌组织内CGA和MR-proADM mRNA转录和蛋白表达.     

降脂通络软胶囊联合瑞舒伐他汀对2型糖尿病合并高脂血症患者效果观察?

目的：观察降脂通络软胶囊联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床疗效,并探讨其可能的机制。方法80例2型糖尿病合并高脂血症患者分为联合组与对照组(n=40)。在常规治疗基础上,联合组给予口服瑞舒伐他汀10 mg,1次/天,降脂通络软胶囊100 mg,3次/天口服,对照组予瑞舒伐他汀10 mg,1次/天,口服,连续用药12周。治疗前后分别检测肝功能、肾功能、肌酸激酶,各项血脂指标。结果治疗12周后,联合组在降低血清胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及超敏 C-反应蛋白(hs-CRP)方面和升高高密度脂蛋白胆固醇(HDL-C)明显优于对照组,差异有统计学意义(P <0.05)。结论瑞舒伐他汀能有效治疗2型糖尿病高脂血症,联合降脂通络软胶囊应用疗效更佳,并且安全性良好。     

瑞舒伐他汀对急性冠状动脉综合征合并心律失常患者血脂和炎症因子的调节作用研究

目的：探讨瑞舒伐他汀对急性冠状动脉综合征（ACS ）合并心律失常患者血脂和炎症因子的调节作用。方法于2010年2月至2012年12月,将102例ACS合并心律失常患者分为A组和B组,每组患者51例。A组给予瑞舒伐他汀组治疗,B组给予阿托伐他汀治疗。比较两组患者治疗前后低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、白细胞介素-18和C反应蛋白水平。结果两组患者治疗后血脂及炎症指标水平与治疗前比较差异均有统计学意义,且治疗后A组血脂及炎症指标改善程度均较B组更为明显（P＜0．05）。结论瑞舒伐他汀对ACS合并心律失常患者体内脂代谢水平和炎症状态均有一定的调节作用,可用于ACS合并心律失常患者的临床治疗。     

瑞舒伐他汀对不稳定型心绞痛患者PCI术后心肌损伤的保护作用

目的探讨瑞舒伐他汀在不稳定型心绞痛（UAP）经皮冠状动脉介入（PCI）术中对心肌损伤的保护作用。方法94例经PCI治疗的UAP患者随机分为观察组（n=47）与对照组（n=47）,观察组在常规治疗基础上给予瑞舒伐他汀治疗,对照组在常规治疗基础上给予阿托伐他汀治疗,对比2组患者心肌损伤情况。结果2组患者术前肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）、人心型脂肪酸结合蛋白（h-FABP）以及超敏C反应蛋白（hs—CRP）及氧化亚氮（N0）比较差异均无统计学意义（P〉0．05）。术后2个月时,观察组上述5项指标均无显著改变（P〉0．05）;对照组CK-MB、cTnI、h-FABP及hs-cRP均显著高于术前（P〈0．01）,术后NO显著低于术前（P〈0．01）。结论瑞舒伐他汀对UAP患者PCI术后心肌损伤具有有效的保护作用,安全可靠,值得推广。     

处方工艺对瑞舒伐他汀钙片混合均匀度及含量均匀度的影响

目的 研究处方中的辅料及工艺对瑞舒伐他汀钙片混合均匀度及含量均匀度的影响。方法 采用粉末直接压片工艺，通过单因素试验，考察处方中乳糖的型号、微晶纤维素的型号、乳糖与微晶纤维素的比例、钙盐的种类及交联聚维酮用量对混合均匀度及含量均匀度的影响；同时研究混合工艺对混合均匀度及压片工艺对含量均匀度的影响。结果 不同的乳糖型号（T80、PW80、315）、微晶纤维素型号（PH102、M102、102）、乳糖与微晶纤维素的比例（1:1、3:1、1:3）、钙盐的种类（磷酸钙（细颗粒）、无水磷酸氢钙（细颗粒、细粉）、碳酸钙（细粉））的处方混合均匀度及含量均匀度良好，磷酸钙（粗颗粒）的处方混合均匀度及含量均匀度较差。在混合容器中加入50%的乳糖，之后加入原料药、微晶纤维素、交联聚维酮和磷酸钙，以10 r·min-1混合20~25 min；再加入剩余的乳糖，以10 r·min-1混合15~25 min，物料混合均匀度良好。重力加料器及压片速度（10~20 r·min-1）的含量均匀度良好；强制加料器及压片速度（30 r·min-1）的含量均匀度较差。结论：通过研究筛选出了适合粉末直压工艺的乳糖型号、微晶纤维素型号、乳糖与微晶纤维素比例、钙盐种类及交联聚维酮用量。考察了混合工艺参数范围，优选了重力加料器及压片速度（10~20 r·min-1），获得了良好的混合均匀度和含量均匀度。     

Effect of statins on blood pressure: Analysis on adverse events released by FDA

Objective: As a class of cholesterol-lowering drugs, statins have been reported to cause unexpected decrease in blood pressure (BP). However, most studies in this issue were subject to inadequate study design or very small sample size. The present study was designed to examine the BP-lowering effect of various statins. Methods: Here we retrieved 5.9 million clinical reports submitted to FDA Adverse Event Reporting System (FAERS) from 2004 to 2015. Meta-analysis was performed to estimate the overall reporting odds ratio (ROR) of hypotension adverse events concurrent with various statins (i.e., atorvastatin, simvastatin, and rosuvastatin). Results: Comparing the reporting rate of hypotension event between statins and other drugs found that atorvastatin (pooled ROR = 1.26, adjusted p-value = 8.60 × 10^?4) and simvastatin (pooled ROR = 1.94, adjusted p-value = 4.16 × 10^?45) were significantly associated with reduction in BP. On the other hand, the association between rosuvastatin and hypotension was observed to be nonsignificant (adjusted p-value = 0.65). Conclusion: To our knowledge, this is the first pooled analysis on large-scale data of adverse events to identify the BP-lowering effect of statins. The results will contribute to the development of novel statin-based antihypertensive therapies. In addition, the differential effects of individual statins can warrant subsequent research on the underlying mechanisms of BP control.     

不同剂量瑞舒伐他汀对急性冠脉综合征患者血清sOX40L、MMP-9的影响

目的　探讨不同剂量瑞舒伐他汀对急性冠脉综合征（ACS）患者血清可溶性OX40配体（sOX40L）、基质金属蛋白酶9（MMP-9）的影响。方法　选择ACS患者60例,空白对照组20例。随机将ACS患者分为20 mg瑞舒伐他汀治疗组（20mg组）30例和10 mg瑞舒伐他汀治疗组（10mg组）30例,比较治疗前后各组间血清sOX40L、MMP-9的水平变化。结果　瑞舒伐他汀治疗2周后,两治疗组患者血清sOX40L、MMP-9水平均较治疗前明显降低,差异有统计学意义（P<0.01）。其中20mg组较10mg组降低更为明显,差异有统计学意义（P<0.05）。 结论　ACS患者早期使用较大剂量瑞舒伐他汀可明显减少冠状动脉粥样斑块基质成分的降解和炎症反应,从而起到稳定动脉粥样硬化斑块,改善ACS患者的预后的作用。     

Efficacy comparison of oral rosuvastatin versus oral progesterone and bevacizumab on regression of surgically endometriotic implants in rats

This study hypothesizes that oral rosuvastatin, oral dienogest and intraperitoneal bevacizumab might improve endometriosis in randomly selected female Wistar albino rats with surgically endometriotic implants. Thirty female Wistar albino rats with surgically endometriotic implants were randomized into three treatment groups: oral rosuvastatin (20?mg kg/day; oral rosuvastatin group 1; n?=?10), oral progesterone (dienogest group 2; n?=?10) and intraperitoneal bevacizumab (2.5?mg/kg of single intraperitoneal injection of bevacizumab; bevacizumab group 3; n?=?10), for 10 days. Post-treatment variables were compared. The oral rosuvastatin group showed higher reduction for the glandular epithelium and uterine vessels of histopathological scores values than the oral progesterone group (both, p?p?>?0.017). Endometrial thickness values and uterine volume values were more significantly reduced in the oral rosuvastatin group than the oral progesterone group (both, p?p?>?0.017). In conclusion, oral rosuvastatin and intraperitoneal injection of bevacizumab may cause more significant regression of surgically endometriotic implants in rats than oral progesterone medications.     

Rediscovering bile acid sequestrants

Aim: In the recently published The Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) mega-trial, rosuvastatin significantly reduced cardiovascular events at the expense of a small but significant increase in the risk of developing type 2 diabetes. The increased risk of new-onset diabetes was in keeping with a recent meta-analysis which suggested that statins, with the possible exception of pravastatin, marginally increase the risk of developing type 2 diabetes.
Methods: Although the net effect of rosuvastatin was obviously very positive, we hypothesized that the addition of a bile aid sequestrant to a statin would not only further decrease lipid levels and potentially further decrease cardiovascular events but also protect against the development of diabetes. This is particularly relevant because the bile acid sequestrant, colesevelam, has recently been approved for therapy of diabetes.
Results: Colesevelam like other bile acid sequestrants lowers low-density lipoprotein levels by 16% and C-reactive protein by 22% beyond the reductions that occur with statin therapy alone. Bile acid sequestrants confer lipid-lowering, glucose-lowering, and anti-inflammatory benefits, and have been shown to reduce risk of cardiovascular events.
Conclusions: Therefore, colesevelam should be the most effective and logical agent to add to a statin in the diabetic and insulin-resistant patient, because in addition to lowering cardiac risk it may prevent the development of diabetes, as well as improving glycaemic control in the established diabetic patient.