血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的临床观察

目的:观察血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的效果。方法:选取2017年6月至2018年6月聊城市中医院收治的高血压颈动脉硬化患者92例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组46例。对照组患者给予左旋氨氯地平+阿托伐他汀口服,观察组在对照组基础上加用血府逐瘀汤合温胆汤加减口服。观察患者血压、血脂控制情况,测定颈动脉内膜中层厚度(IMT)、斑块面积、血管皮内皮功能、血清蛋白酶分子水平。结果:与对照组比较,观察组治疗后的血压SBP、DBP及血脂TG、TC、LDL-C等指标更低(P<0.05);颈动脉粥样硬化斑块IMT厚度、斑块面积明显缩小(P<0.05),血管内皮功能指标ET-1、AngⅡ、TXB2水平明显降低,NO水平明显升高(P<0.05);血清CatK、MMP-9水平明显降低(P<0.05);观察组不良反应发生率8.70%明显低于对照组不良反应发生率21.74%(P<0.05)。结论:血府逐瘀汤合温胆汤加减联合西药更利于控制高血压颈动脉硬化患者的血压,调节脂质代谢,改善血管内皮功能,降低血清蛋白酶分子的含量,用药安全。     

通心络胶囊联合阿托伐他汀及氯吡格雷治疗冠心病心绞痛临床研究

目的:观察通心络胶囊联合阿托伐他汀、氯吡格雷治疗冠心病心绞痛的临床疗效。方法:选取84例冠心病心绞痛患者,按随机数字表法分为观察组与对照组,对照组40例给予阿托伐他汀联合氯吡格雷治疗,观察组44例在对照组基础上给予通心络胶囊治疗,3个月后比较2组临床疗效。结果:观察组总有效率(93.18%)显著高于对照组(70.00%),差异有统计学意义(P<0.05)。治疗前,2组心绞痛的持续时间、心绞痛发作次数、心功能指标、血管内皮功能指标比较,差异无统计学意义(P>0.05)。治疗后,2组心绞痛持续时间、心绞痛发作次数较治疗前明显降低,观察组心绞痛持续时间、心绞痛发作次数显著低于对照组(P<0.05);2组心功能指标包括心输出量(CO)、心博出量(SV)、心脏指数(CI)及射血分数(EF)均较治疗前明显上升,且观察组各项心功能指标明显高于对照组(P<0.05);2组内皮功能指标内皮素(ET)、血栓素B2(TXB2)水平较治疗前明显降低,一氧化氮(NO)水平较治疗前明显上升(P<0.05),观察组ET、TXB2水平明显低于对照组,NO水平明显高于对照组(P<0.05)。结论:对冠心病心绞痛患者给予通心络胶囊联合阿托伐他汀、氯吡格雷治疗疗效显著,可有效降低心绞痛持续时间和发作次数,改善患者心功能和内皮功能,值得临床推广应用。     

阿托伐他汀对高血脂症患者的血脂及凝血系统的影响

目的为了探讨阿托伐他汀对血脂异常患者的调脂作用及对凝血系统的影响.方法选择2003年3月～2004年5月在我院门诊治疗或住院的高血脂症患者50例为研究对象,口服阿托伐他汀10毫克,一天一次,展顿服,12周为一个疗程.血脂正常者50例为对照组,分别对高血脂组治疗前和治疗12周后两组进行血脂总胆固醇(TC)、甘油三脂(TG)、低密度脂旦白胆固醇(LDL-C)、高密度脂旦白胆固醇(HDL-C)、纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)检测.结果与治疗前及血脂正常组比较,血脂紊乱组治疗12周后的TC、TG、LDL-C、FIB,均有显著降低p＜0.01,HD1-C,明显升高,p＜0.05,APTT均有显著延常,p＜0.01,PT明显升高,p＜0.05,TC、TG、LDL-C、HDL-C、FIB,PT均接近血脂正常组各项检测指标,比较无明显差异p＞0.05,APTT均超出血脂正常组,比较有显著差异p＜0.05.结论阿托伐他汀在有效调脂治疗的同时,可改善凝血系统.     

The Lipid-regulating Effects of Atorvastatin on Type 2 Elder Diabetes Patients with Hyperlipidemia

Inthisstudy,theeffectofatorvastatinonlipidmetabolism ,especiallysLDL ,intype 2elderdiabetespatientswithhyperlipidemiawasstudy .Theresultswerepresentedasfollows.1　SUBJECTSANDMETHODS1 1　SubjectsThesubjectsincluded 2 6patientswithtype 2elderdiabetesandhyp…     

阿托伐他汀对冠心病患者肱动脉内皮依赖性舒张功能的影响

目的：应用高频超声观察冠心病（CAD）患者，经阿托伐他汀治疗后对肱动脉内皮依赖性舒张功能（EDD）的改善作用。方法：经冠脉造影（CAG）确诊为CAD患者59例，利用高频超声血管技术检测阿托伐他汀对CAD患者治疗前后肱动脉EDD的疗效。结果：阿托伐他汀治疗2年后，EDD比治疗前有明显改善（P〈0．05），与对照组相比无显著性差异（P〉0．05）。常规治疗组治疗2年后，EDD无明显改善（P〉0．05），与阿托伐他汀组治疗后及对照组相比差异有显著性（P〈0．05）。结论：阿托伐他汀具有改善EDD的作用。     

阿托伐他汀治疗混合型高脂血症的疗效观察

目的　评价阿托伐他汀治疗混合型高脂血症的疗效。方法　将 6 2例高脂血症患者随机分为A、B两组 ,A组 32例 ,给予阿托伐他汀 10mg d,4周后血清胆固醇未下降 10 %者 ,可增量到 2 0mg d ;B组 30例 ,给予氟伐他汀2 0mg d,4周后血清胆固醇未下降 10 %者 ,可加量到 4 0mg d,两组均治疗 8周 ,观察降脂疗效。结果　阿托伐他汀组 ,总胆固醇 (TC)从 (6 83± 0 86 )mmol L降至 (4 6 8± 0 84 )mmol L ;甘油三酯 (TG)从 (3 16± 0 81)mmol L降至(2 0 4± 0 76 )mmol L ;低密度脂蛋白胆固醇 (LDL -C)从 (3 94± 1 2 2 )mmol L降至 (2 32± 0 77)mmol L (P均 <0 0 1)。两组降脂疗效间差别无显著性意义 (P >0 0 5 ) ,但治疗后两组患者的TG、LDL -C含量间差别有显著性意义(P <0 0 5 )。结论　阿托伐他汀有明显降TC、LDL -C、TG的作用 ,可用于混合型高脂血症的治疗     

Effects of atorvastatin on arterial endothelial function in coronary bypass surgery

Objective: Endothelial dysfunction represents a critical early component of organ injury following cardiopulmonary bypass. Recent studies demonstrate that the treatment with atorvastatin is associated with a significant improvement of endothelial function independently of its efficacy on cholesterol levels. Therefore, we investigated the effects of preoperative atorvastatin treatment on endothelium function after coronary surgery. Methods: Forty patients undergoing coronary surgery were randomized to treatment with atorvastatin (20 mg/die; N = 20) or placebo (N = 20) 3 weeks before surgery. Twenty normal patients served as control group. The flow-mediated dilations (FMD) of the brachial artery after both reactive hyperemia (endothelium dependent) and nitroglycerin administration (endothelium independent) were evaluated at baseline, at 48 h, and 5 days postoperatively. Results: At baseline, the endothelium-dependent FMD was significantly attenuated in coronary versus normal patients (normal 10.3 ± 1.8% vs coronary 4.1 ± 1.6%, p < 0.01). At 48 h postoperatively all patients exhibited a reduced FMD compared with baseline values: the endothelium-dependent dilatation showed a drop of 60.1 + 15% in the patients of the placebo group compared with 45.8 + 16.6% (p < 0.05) those in the atorvastatin group. At the univariate analysis, no significant correlation was found between serum levels of either total cholesterol or HDL cholesterol and FMD. The nitroglycerin-induced dilation was not significantly influenced by extracorporeal circulation as well as by atorvastatin treatment. Conclusions: The endothelial dysfunction following cardiopulmonary bypass is improved by the treatment with atorvastatin, by a mechanism unrelated to the drug efficacy of controlling serum cholesterol levels.     

阿托伐他汀对系膜增殖性肾炎大鼠肾组织细胞外基质和纤溶酶原激活剂抑制物-1表达的影响

目的：观察阿托伐他汀对系膜增殖性肾炎（MsPGN）大鼠肾组织细胞外基质（ECM）和纤溶酶原激活剂抑制物-1（PAI-1）表达的影响，探讨其肾脏保护作用的机制。方法：采用抗胸腺细胞血清诱发的MsPGN大鼠模型，将SD大鼠随机分为正常对照组、肾炎模型组、小剂量阿托伐他汀治疗组（8mg·kg^-1·d^-1）和大剂量阿托伐他汀治疗组（16mg·kg^-1·d^-1）。治疗12d后。检测各组大鼠血总胆固醇（CHOL）、甘油三酯（TG）、血肌酐（Scr）和24h尿蛋白，以及肾组织Ⅳ型胶原（Col Ⅳ）、纤维结合蛋白（FN）和PAI-1的表达。结果：阿托伐他汀治疗组大鼠24h尿蛋白、肾组织Col Ⅳ、FN和PAI-1 mRNA的表达明显下降。肾组织病理改变明显改善，与模型组相比有统计学差异（P〈0．05），且呈剂量依赖关系。其中肾炎模型组尿蛋白（30．34±0．62）mg／d。阿托伐他汀小剂量治疗组（21．17±0．79）mg／d，大剂量治疗组（9．77±0．54）mg／d。同时，各组血脂水平无明显差异（P〉0．05）。结论：阿托伐他汀可显著改善MsPGN大鼠肾脏病变，抑制肾组织ECM成分和PAI-1的表达。     

Determination of the relative bioavailability of nedocromil sodium to the lung following inhalation using urinary excretion

Objective: To determine the effects of cimetidine on the steady-state pharmacokinetics and pharmacodynamics of atorvastatin, a 3-hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitor. Methods: Twelve healthy subjects participated in a randomized two-way crossover study. Each subject received atorvastatin 10 mg every morning for 2 weeks and atorvastatin 10 mg every morning with cimetidine 300 mg four times a day for 2 weeks, separated by a 4-week washout period. Steady-state pharmacokinetic parameters (based on an enzyme inhibition assay) and lipid responses were compared. Results: Pharmacokinetic parameters and lipid responses were similar following administration of atorvastatin alone and atorvastatin with cimetidine. Mean values for C_max (the maximum concentration) were 5.11 ng · eq · ml⁻¹ and 4.54 ng eq · ml⁻¹, for t_max (the time to reach maximum concentration) 2.2 h and 1.3 h, for AUC_0–24 (area under the concentration-time curve from time 0 h to 24 h) 58.6 ng eq · h · ml⁻¹ and 58.5 ng eq · h · ml⁻¹, and for t_1/2 (terminal half-life) 10.1 h and 17.0 h, respectively, following administration of atorvastatin alone and atorvastatin with cimetidine. Following treatment with atorvastatin alone and atorvastatin with cimetidine, mean values for the percentage change from baseline for total cholesterol were −29.5% and −29.9%, for low-density lipoprotein (LDL) cholesterol −41.0% and −42.6%, for high-density lipoprotein (HDL) cholesterol 6.3% and 5.8%, and for triglycerides −33.8% and −25.8%, respectively. Conclusions: The rate and extent of atorvastatin absorption and the effects of atorvastatin on LDL-cholesterol responses are not influenced by coadministration of cimetidine. Received: 17 February 1997 / Accepted in revised form: 3 November 1997     

ACAT-1 rs1044925单核苷酸多态性与急性冠脉综合征及阿托伐他汀治疗后血脂反应的关系研究

背景 既往研究显示ACAT-1 rs1044925单核苷酸多态性（SNP）与冠心病及缺血性脑卒中的发病风险相关,并且与血脂水平有关。目的 本研究旨在探讨ACAT-1 rs1044925 SNP与急性冠脉综合征（ACS）的关系,以及rs1044925 SNP与ACS患者阿托伐他汀治疗后调脂效果的关系。方法 选择2016年1月—2018年1月在广西壮族自治区人民医院老年心血管内科确诊为ACS并接受经皮冠状动脉介入治疗（PCI）的患者111例作为ACS组（男67例,女44例）;患者均接受阿托伐他汀治疗,20 mg/晚;同时服用氯吡格雷75 mg,1次/d（或替格瑞洛90 mg,2次/d）,阿司匹林100 mg,1次/d;并在经PCI后常规使用阿托伐他汀,20 mg/晚。对照组为同期体检健康人群,共338例（男170例,女168例）。通过聚合酶链反应和限制性片段长度多态性（PCR-RFLP）对ACAT-1 rs1044925 SNP进行基因分型,检测ACS组和对照组的基线血脂水平,随访检测ACS组患者阿托伐他汀治疗1年后血脂参数。结果 ACS组和对照组受检者的血清总胆固醇（TC）间差异无统计学...