瑞舒伐他汀与阿托伐他汀在治疗冠心病中的比较分析

目的探讨阿托伐他汀以及瑞舒伐他汀应用于冠心病患者的治疗效果以及安全性。方法选取冠心病患者92例,将患者按照随机数字表法分为阿托伐他汀组和瑞舒伐他汀组,每组46例。阿托伐他汀组予以阿托伐他汀20 mg/d口服治疗,瑞舒伐他汀组采用瑞舒伐他汀10 mg/d口服治疗。比较两组患者治疗前后的血浆血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并统计血脂达标率。结果两组患者治疗后的TC、LDL-C水平均较治疗前明显改善,但是与阿托伐他汀组相比,瑞舒伐他汀组患者改善的幅度更加明显,组间比较差异有统计学意义(P<0.05)。结论采用2种他汀类药物均可以改善冠心病患者的血脂水平,但是瑞舒伐他汀在改善冠心病患者的血脂方面效果更好。     

匹伐他汀钙片治疗高胆固醇血症的有效性和安全性研究

目的 评价匹伐他汀钙片治疗高胆固醇血症的有效性和安全性.方法 360例高胆固醇血症患者接1∶1∶1比例随机分为匹伐他汀钙片l mg组、2 rng组和阿托伐他汀钙片10 mg组,经4周筛选期后,符合入选标准的患者接受l mg/2 mg匹伐他汀钙片或10 mg阿托伐他汀钙片治疗(一日1次,口服),治疗8周,观察各组治疗前后血清低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)和甘油三酯(TG)变化情况.结果 治疗8周后各组LDL-C下降显著,分别为-30.06％、-35.04％和-34.34％,组间差异无统计学意义.匹伐他汀钙片2 mg组降低LDL-C的疗效非劣于阿托伐他汀钙片组,匹伐他汀钙片1 mg组降低LDL-C的疗效劣于阿托伐他汀钙片组.治疗4、8周后匹伐他汀钙降低TC、HDL-C和TG作用与阿托伐他汀钙比较差异无统计学意义.结论 匹伐他汀钙片治疗高胆固醇血症安全有效.     

瑞舒伐他汀与阿托伐他汀对冠心病患者血脂、动脉粥样硬化程度和血管内皮舒张功能的疗效对比

目的:对比瑞舒伐他汀与阿托伐他汀对冠心病患者血脂、动脉粥样硬化程度和血管内皮舒张功能的疗效。方法:选择2014年1月-2015年12月于我院心血管内科住院的冠心病患者150例,按照抽签法分为瑞舒伐他汀组(72例)和阿托伐他汀组(78例)。所有患者均调整生活习惯,给予抗血小板和调整血压药物等基础治疗。同时,瑞舒伐他汀组患者给予瑞舒伐他汀钙片10 mg,po,每晚1次;阿托伐他汀组患者给予阿托伐他汀钙片20 mg,po,每晚1次。两组患者均治疗6个月。比较治疗前后两组患者的血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平、颈动脉内-中膜厚度(IMT)、颈动脉斑块积分(Crouse积分)、冠状动脉狭窄程度评分(Gensini评分)和肱动脉内径变化百分率(D),记录不良反应发生情况。结果:治疗前,两组患者上述各指标比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的TC、TG、LDL-C、IMT、Crouse积分和Gensini评分均较治疗前显著下降,HDL-C和D值较治疗前显著上升,且瑞舒伐他汀组患者的TC、TG、LDL-C、Crouse积分和Gensini评分均显著低于阿托伐他汀组,D值显著高于阿托伐他汀组,差异均有统计学意义(P<0.05);但两组患者的HDL-C和IMT比较,差异均无统计学意义(P<0.05)。治疗过程中,瑞舒伐他汀组有1例患者出现头晕,后自行缓解;两组各有4例患者出现转氨酶轻度升高,经护肝治疗后恢复正常。结论:瑞舒伐他汀在降低冠心病患者血脂、改善AS和血管内皮舒张功能方面较阿托伐他汀疗效更显著,且安全性较高。     

大剂量阿托伐他汀辅治早期急性心肌梗死疗效观察

目的观察大剂量阿托伐他汀辅治早期急性心肌梗死(AMI)的临床疗效。方法将60例AMI患者随机分为治疗组和对照组各30例。所有患者入院后均给予溶栓治疗。溶栓后,治疗组再给予阿托伐他汀80mg口服,每晚1次;对照组给予阿托伐他汀20mg口服,每晚1次。观察2组临床疗效和丙氨酸氨基转移酶(ALT)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平变化情况和不良反应。结果治疗组显效率为83.3%高于对照组的60.0%,差异有统计学意义(P<0.05)。治疗后2组患者TC、LDL-C均下降,且治疗组LDL-C下降较对照组更明显,差异有统计学意义(P<0.05)。2组均无严重不良反应发生。结论 AMI患者早期应用大剂量阿托伐他汀治疗临床效果明显,不良反应小,安全可靠。     

不同剂量阿托伐他汀治疗颈动脉粥样硬化对比分析

目的 观察不同剂量阿托伐他汀对颈动脉粥样硬化的临床疗效.方法 选择存在有不同程度的颈动脉粥样硬化并有斑块形成的患者118例,随机分为2组.治疗组56例,服用阿托伐他汀20mg,每晚1次;对照组62例,服用阿托伐他汀10mg,每晚1次,疗程4个月(16周).观察治疗前后颈动脉内膜-中层厚度(IMT)以及胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的变化.结果 阿托伐他汀10mg、20mg均能明显减轻颈动脉粥样硬化,降低TC、TG、LDL-C水平,升高HDL-C水平.治疗组较对照组能更进一步降低降低IMT(P＜0.05)、TC、LDL-C(P＜0.05)和升高HDL-C水平(P＜0.05).结论 阿托伐他汀可以明显减轻颈动脉粥样硬化病变,有效降低血脂水平,可作为治疗颈动脉粥样硬化的常规用药.     

阿托伐他汀对冠心病伴高脂血症患者血脂的影响

目的 探讨阿托伐他汀10mg／d口服在冠心病降脂治疗的效果，观察不良反应及对临床心脏事件的影响。方法冠心病患者伴高脂血症30例口服阿托伐他汀10mg后，在治疗前和治疗后4、8周测定总胆固醇（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）水平的变化，同时观察冠心病患者6个月随访期间主要心脑血管事件发生情况。结果阿托伐他汀治疗4周后TC、TG、LDL-C水平显著降低（P〈0．05）。结论短期阿托伐他汀可有效降低冠心病患者血清中Tc、TG、LDL-C水平，而且随访期间复发性心绞痛、心衰、心律失常等发生率均较平时明显降低。     

阿托伐他汀治疗冠心病患者高脂血症临床观察

目的 观察阿托伐他汀(立普妥)治疗冠心病伴高脂血症的临床效果.方法 选择2009年1月至2011年3月冠心病伴高脂血症患者120例为观察对象,随机分为观察组60例和对照组60例,两组均按冠心病伴高脂血症常规内科治疗,观察组加用阿托伐他汀10 mg,1次/天口服,疗程12周,统计分析治疗前后两组血脂水平变化及心绞痛,心律失常发作次数、心力衰竭及脑卒中事件,不良反应等情况.结果 观察组治疗后总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)及甘油三酯(triacylgly cerol,TG)水平均较治疗前下降显著,而高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)水平升高明显(P＜0.01),而对照组治疗前后TC、LDL-C及TG水平差异无统计学意义(P＞0.05);观察组治疗期间平均发生心绞痛、心律失常及心力衰竭加重例数显著低于对照组,同时无脑卒中事件发生(P＜0.01);观察组不良反应发生率略高于对照组,但差异无统计学意义(P＞0.05).结论 阿托伐他汀能快速降低冠心病患者血脂水平,降低心脑血管事件发生,缓解冠心病患者临床症状,安全性好,可于临床广泛应用.     

他汀药物对脑梗死患者血脂和高敏C反应蛋白影响的临床研究

目的:观察他汀类药物对脑梗死患者血脂和高敏C反应蛋白(hs-CRP)影响。方法:选择100例脑梗死患者,随机分为A组(阿托伐他汀20mg/d)、B组(阿托伐他汀40mg/d)各50例,并给予抗血小板聚集药物来预防卒中复发,治疗1个月后观察治疗前和治疗后血脂和hs-CRP变化。结果:阿托伐他汀20mg/d和40mg/d组患者的总胆固醇(total cholesterol,TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和hs-CRP水平均下降,其中40mg/d组下降的最明显,差异有统计学意义;阿托伐他汀20mg/d和40mg/d组高密度脂蛋白胆固醇(HDL-C)水平治疗前后均有升高趋势,且40mg/d组HDL-C升高水平高于20mg/d组,差异有统计学意义。结论:阿托伐他汀具有降TC、TG、LDL-C和升高HDL-C水平及抗炎作用,且40mg/d组降TC、TG、LDL-C和升高HDL-C水平及抗炎作用强于20mg/d组。     

阿托伐他汀类药物治疗血脂紊乱的临床观察

目的观察阿托伐他汀治疗高血脂症的临床疗效。方法选择符合条件的高血脂症住院患者60例,给予口服阿托伐他汀10 mg,每日1次,患者在治疗期间进行标准的低胆固醇饮食维持合理的膳食。所有患者于治疗前及治疗后2周、4周,采用酶联免疫吸附法测定血浆总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C)及甘油三脂(TG)的浓度,同时用药前后检测肝、肾功能、血浆肌酸激酶(CK)、血常规、心电图各一次。结果60例高脂血症患者中,36例患者在服用阿托伐他汀钙片2周后,TC、LDL-C及TG有不同程度的改善,有效率为60%。有24例患者降低效果未达标,治疗4周后,14例患者的TC、LDL-C及TG指标中有1~2项达到有效,总有效率为83.3%。有4例患者服用阿托伐他汀钙片TC、LDL-C及TG下降不明显。经统计学分析,治疗前后有显著差异(P<0.05)。结论阿托伐他汀类药物治疗高血脂症患者取得了较好的疗效。     

阿托伐他汀对稳定性冠心病患者血脂、脂蛋白（a）水平影响的临床观察

目的探讨不同剂量阿托伐他汀对稳定性冠心病患者血脂及脂蛋白(a)[Lp(a)]水平的影响。方法将300例稳定性冠心病患者随机分为甲、乙、丙三组每组100例,分别应用10 mg、20 mg、40 mg阿托伐他汀治疗,测定三组治疗前、治疗12个月血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及Lp(a)水平,评估安全性。结果①治疗12个月,TC、TG、LDL-C、Lp(a)比较:丙组<乙组<甲组(P<0.05),三组HDL-C比较无差异(P>0.05);②三组各不良反应发生率比较差异无统计学意义(P>0.05);③稳定性冠心病患者Lp(a)与TC、TG、LDL-C、HDL-C无相关性(P>0.05)。结论阿托伐他汀可降低稳定性冠心病患者TC、TG、LDL-C、Lp(a)水平,上调HDL-C水平,以大剂量阿托伐他汀疗效更显著。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.