瑞舒伐他汀与阿托伐他汀治疗冠心病的效果对比观察

目的 比较瑞舒伐他汀与阿托伐他汀治疗冠心病的临床效果.方法 随机将128例在本院心内科住院的冠心病患者分为观察组和对照组各64例,观察组每晚给予瑞舒伐他汀10 mg服用,对照组每晚给予同等剂量的阿托伐他汀服用,连续21 d后观察比较两组患者治疗前后血脂情况的变化和安全情况.结果 治疗后两组血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均较治疗前降低,观察组高密度脂蛋白胆固醇（HDL-C）水平较治疗前升高,差异有统计学意义（P＜0.05）,且观察组血脂水平改善程度优于对照组（P＜0.05）.观察组总有效率为95.3％,对照组总有效率为87.5％,观察组总有效率明显高于对照组（P＜0.05）.观察组不良反应发生率明显低于对照组（P＜0.05）.结论 在同等剂量下,瑞舒伐他汀的调脂效果和安全情况显著高于阿托伐他汀.     

加味补阳还五汤对动脉硬化模型家兔血脂、CRP 变化的影响

目的：评价加味补阳还五汤对动脉硬化模型家兔血脂、CRP变化的影响。方法健康新西兰兔68只随机分为：正常对照组,高脂对照组、阿托伐他汀组、加味补阳还五汤组,共4组;除正常对照组外,其余新西兰兔采用高胆固醇饲料并免疫损伤诱发的动脉粥样硬化斑块模型,观察各组血脂和C-反应蛋白（CRP）变化并比较。结果对血脂的影响：高脂对照组与正常对照组比较,血清总胆固醇（TC）、甘油三酯（TG）及低密度脂蛋白胆固醇（LDL-C）均升高,差异均有统计学意义（P＜0．05）;阿托伐他汀组及加味补阳还五汤组TC、LDL-C均明显低于高脂对照组（P＜0．05）,高密度脂蛋白胆固醇（HDL-C）高于正常对照组和高脂对照组（P＜0．05）,阿托伐他汀组与加味补阳还五汤组比较差异无统计学意义（P＞0．05）;对CRP的影响：高脂对照组明显高于正常对照组（P＜0．05）,加味补阳还五汤、正常对照组、阿托伐他汀组间比较差异均无统计学意义（P＞0．05）。结论加味补阳还五汤具有抑制动脉粥样硬化的作用,可能是通过调脂、抗炎作用来完成。     

不同剂量阿托伐他汀对急性冠状动脉综合征患者血浆P选择素的影响

目的 探讨不同剂量的阿托伐他汀对急性冠状动脉综合征患者血浆中P选择素的影响.方法 将120例急性冠状动脉综合征患者完全随机分为2组.对照组（40例）予常规治疗,阿托伐他汀治疗组（80例）在常规治疗的基础上加用阿托伐他汀口服,1次/d.同时根据阿托伐他汀的用量,将阿托伐他汀组分为阿托伐他汀10 mg组及阿托伐他汀40mg组.在治疗前及治疗1周后分别测量血浆P选择素水平.结果 3组治疗前P选择素水平差异无统计学意义（P＞0.05）.治疗后3组P选择素水平均下降,与治疗前比较,差异有统计学意义[对照组、阿托伐他汀10 mg组及阿托伐他汀40 mg组分别为（119.2±78.9）μg/L,（88.8±63.9）μg/L、（56.4±53.1）μg/L,P＜0.05],阿托伐他汀治疗组降幅大于对照组,其中阿托伐他汀40 mg组下降幅度更明显,与10 mg组比较,差异有统计学意义（P＜0.05）.结论 阿托伐他汀可使冠心病血浆中P选择素明显下降,这可能与其能抑制白细胞和血小板与内皮的黏附聚集有关;早期予强化高剂量的阿托伐他汀治疗可能获得更大的益处.     

对混合性高脂血症实施阿托伐他汀与非诺贝特治疗的临床效果

目的：观察混合性高脂血症实施阿托伐他汀与非诺贝特治疗的临床效果。方法：选取2012年3月～2015年2月东莞市黄江医院收治的混合性高脂血症患者106例作为研究对象,按照计算机数字法分为对照组（n=53）和治疗组（n=53）,对照组采用阿托伐他汀治疗,治疗组采用阿托伐他汀联合非诺贝特治疗,比较两组治疗效果。结果：经过1个疗程的治疗,两组TG、TC、LDL-C、HDL-C等血脂指标与治疗前相比,差异明显（P＜0.05）,治疗组TG、LDL-C改善情况优于对照组（P＜0.05）,治疗总有效率96.2%明显高于对照组79.3%,组间差异具有统计学意义（P＜0.05）。结论：混合性高脂血症实施阿托伐他汀与非诺贝特治疗效果确切,协同作用良好,可显著改善临床症状,提高调脂效果,具有临床推广价值。     

瑞舒伐他汀、阿托伐他汀在冠状动脉粥样硬化性心脏病调脂治疗中的药物经济学研究

目的 探讨瑞舒伐他汀、阿托伐他汀在冠状动脉粥样硬化性心脏病（以下简称“冠心病”）患者调脂治疗中的药物经济学。方法 选取2020年7月至2021年7月吉林市人民医院收治的84例行调脂治疗的冠心病患者作为研究对象,采用随机数字表法分为观察组和对照组,每组42例。在基础治疗的基础上观察组采用瑞舒伐他汀进行调脂治疗,对照组则采用阿托伐他汀进行调脂治疗。两组均治疗8周,测定两组患者的低密度脂蛋白胆固醇（LDL-C）,比较两组患者的调脂效果,并采用成本-效果分析法对瑞舒伐他汀、阿托伐他汀两种药物的经济学进行评价。结果 两组治疗前的LDL-C水平比较,差异无统计学意义（P>0.05）;两组治疗后的LDL-C水平均低于本组治疗前,差异有统计学意义（P<0.05）;两组治疗后的LDL-C水平比较,差异无统计学意义（P>0.05）。两组调脂的总有效率比较,差异无统计学意义（P>0.05）。两组的不良反应总发生率比较,差异无统计学意义（P>0.05）。瑞舒伐他汀、阿托伐他汀治疗的成本-效果比分别为3.58元/%、4.03元/%,瑞舒伐他汀的增量成本-效果比为-4.30元/%。敏...     

化痰通络汤结合阿托伐他汀钙片对风痰阻络型急性脑梗死患者的疗效

目的：分析风痰阻络型急性脑梗死（ACI）患者应用化痰通络汤结合阿托伐他汀钙片的效果。方法：采用随机数字表法将2020年1月至2021年10月乐平市中医院治疗的90例ACI患者分为两组,各45例。对照组予以常规治疗+阿托伐他汀钙片治疗,观察组加用化痰通络汤治疗,均连续治疗3周。分析两组临床疗效、血脂水平、颈动脉粥样硬化（CAS）斑块指标、炎症因子水平及不良反应。结果：连续治疗3周,临床总有效率观察组较对照组高,总胆固醇（TC）、三酰甘油（TG）、颈动脉内-中膜厚度（IMT）值、斑块面积、斑块总积分、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)观察组较对照组低,均差异有统计学意义（P<0.05）。两组未见严重不良反应。结论：风痰阻络型ACI患者应用化痰通络汤结合阿托伐他汀钙片治疗可降低CAS斑块面积、IMT值、斑块总积分及血脂水平,减轻炎症反应,是一种安全、有效的治疗方案。     

阿托伐他汀钙片对急性脑梗死患者血清C-反应蛋白的影响

目的研究阿托伐他汀钙片对急性脑梗死患者血清C-反应蛋白含量的影响及意义。方法将104例脑梗死患者随机分为阿托伐他汀钙片组和对照组。阿托伐他汀钙片组在对照组基础上每天加服阿托伐他汀钙片20mg,检测治疗前后血清CRP含量。结果阿托伐他汀钙片组治疗后血清CRP较对照组下降明显,差异有统计学意义(P<0.05)。结论阿托伐他汀钙片能够降低脑梗死患者血清CRP水平,可能与抑制炎症反应有关。     

瑞舒伐他汀与阿托伐他汀治疗高胆固醇血症的临床对比观察

目的：对比瑞舒伐他汀和阿托伐他汀治疗老年高胆固醇血症患者的临床疗效。方法将76例高脂血症患者随机分为研究组和对照组各38例。对照组予阿托伐他汀,研究组予瑞舒伐他汀。于每晚入睡前服用,分别于受试后的4周和8周随访,抽空腹肘静脉血,测定2组TC、TG、LDL-C、HDL-C。结果治疗前2组TC、TG、HDL-C、LDL-C水平差异无统计学意义（P＞0．05）。治疗后第4、8周2组TC、TG、LDL-C水平低于治疗前,HDL-C水平高于治疗前,且研究组优于对照组,差异均有统计学意义（P＜0．05）。研究组LDL-C达标率为89．5％高于对照组的76．3％,差异均有统计学意义（ P＜0．05）。结论瑞舒伐他汀组、阿托伐他汀组均能明显降低TC、TG、LDL-C,升高HDL-C,调脂疗效确切。瑞舒伐他汀的临床疗效优于阿托伐他汀,剂量更小,价格相对低廉,安全性相当,值得临床推广使用。     

氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的疗效观察

目的：探讨氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的临床疗效。方法：73例高血压合并冠心病患者分为观察组（40例）和对照组（33例）,分别给予氨氯地平阿托伐他汀钙片和硝苯地平缓释片治疗,比较两组临床治疗效果。结果：两组治疗后血压、血脂有所下降,观察组下降更为明显,治疗总有效率（95.5%）高于对照组（78.8%）,差异显著（P＜0.05）。结论：氨氯地平阿托伐他汀钙片具有降压、降脂作用,用于治疗高血压合并冠心病,疗效确切,值得在临床上推广。     

阿托伐他汀钙片联合依那普利治疗慢性心力衰竭伴高尿酸血症的临床观察

目的观察阿托伐他汀钙片联合依那普利对慢性心力衰竭患者血清尿酸（UA）水平的影响。方法将60例慢性心力衰竭患者随机分为治疗组和对照组各30例。对照组予依那普利片治疗,治疗组在对照组基础上加阿托伐他汀钙片治疗。2组均2周为1个疗程,治疗4个疗程。观察2组治疗前后UA水平。结果治疗组总有效率为90．0％高于对照组的60．0％,差异有统计学意义（P〈0．01）。治疗后2组uA水平均低于治疗前,且治疗组低于对照组,差异有统计学意义（P〈0．05）。结论阿托伐他汀钙片联合依那普利能有效降低慢性心力衰竭患者uA水平。     

A comparison of mirex-induced liver growth to liver regeneration

In intact rats given a single oral dose of mirex there was a dose-dependent increase in liver weight which peaked at 4 days. There were increases in hepatic RNA and protein, but DNA content per liver and DNA synthesis as measured by [3H]thymidine incorporation were unchanged. In partially hepatectomized rats dosed with mirex 24 h post-surgery, there was a dose-dependent increase in relative liver weight which peaked at 5 days. In partially hepatectomized rats simultaneously dosed with mirex, [3H]thymidine incorporation into DNA was unaltered. However, in rats dosed with mirex 24 h prior to partial hepatectomy, there was a 50% reduction in [3H]thymidine incorporation into hepatic DNA.     

肝损状态下尿苷二磷酸葡萄糖醛酸转移酶研究进展

肝脏是人体内最重要的代谢器官,包含绝大部分的Ⅰ相和Ⅱ相代谢酶,在内源性和外源性物质的代谢解毒方面起着重要的作用.参与葡萄糖醛酸代谢的尿苷二磷酸葡萄糖醛酸转移酶(UGT)是Ⅱ相代谢中最重要的酶,与常见的CYP450酶相比,研究相对滞后,尤其在肝损伤状态下UGT的相关研究仍处于探索阶段.本文参考最新UGT的研究成果,综述了UGT分子生物学目前研究的概况、肝脏分布及其与肝脏疾病的关系;总结了几种不同诱因的肝损伤病理状态UGT表达和葡萄糖醛酸代谢的变化情况并且深入探讨了相关机制,旨在为药物的肝脏代谢尤其是在肝损状态下葡萄糖醛酸结合消除研究提供一定的参考依据,为肝脏疾病患者的临床合理用药提供指导.     

An in vitro method of alcoholic liver injury using precision-cut liver slices from rats

Alcohol abuse results in liver injury, but investigations into the mechanism(s) for this injury have been hampered by the lack of appropriate in vitro culture models in which to conduct in depth and specific studies. In order to overcome these shortcomings, we have developed the use of precision-cut liver slices (PCLS) as an in vitro culture model in which to investigate how ethanol causes alcohol-induced liver injury. In these studies, it was shown that the PCLS retained excellent viability as determined by lactate dehydrogenase and adenosine triphosphate (ATP) levels over a 96-h period of incubation. More importantly, the major enzymes of ethanol detoxification; alcohol dehydrogenase, aldehyde dehydrogenase, and cytochrome P4502E1, remained active and PCLS readily metabolized ethanol and produced acetaldehyde. Within 24 h and continuing up to 96h the PCLS developed fatty livers and demonstrated an increase in the redox state. These PCLS secreted albumin, and albumin secretion was decreased by ethanol treatment. All of these impairments were reversed following the addition of 4-methylpyrazole, which is an inhibitor of ethanol metabolism. Therefore, this model system appears to mimic the ethanol-induced changes in the liver that have been previously reported in human and animal studies, and may be a useful model for the study of alcoholic liver disease.     

门冬氨酸鸟氨酸对肝切除术后肝功能保护作用的研究

Objective To investigate the protective effects of L-Ornithine-L-Aspartate on liver function in patients after liver resection. Methods Eighty-two patients undergoing liver resection were randomly divided into study group and control group. Control group was treated with conventional therapy and study group had conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the seven day after operation. The fasting alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), γ-glutamyl transpeptadase(GGT), total bilirubin(TB), direct bilirubin(DB) and blood ammonia(BA) levels were determined before operation and on days 1, 3 and 7 after operation. Results On days 1, 3 and 7 after operation, ALT and AST levels in the study group [ALT: ( 115.58 ± 69. 20), (81. 36 ± 14. 55 ), ( 61.24 ± 11. 32) U/L; AST: ( 127.29 ±33.61 ), (95.26 ± 16.83 ), (55.16 ± 14.83 )U/L] were significantly lower than those in the control group[ALT:(175.27 ±68.35), (97.37 ±34.24), (78.28 ± 19. 73) U/L;AST: (152. 29 ±31.65), (115.28 ±35.24),(82.49 ± 28.18) U/L] (P ＜ 0.05 ). In the study group of the porta blocked over 15 min, levels of AST, ALT were obviously lower than that of the control group( P ＜ 0. 05 ). Conclusions L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy, especially in the long time of porta blocked and has protective advantage for liver function.     

人工肝支持系统在肝移植围手术期的应用

目的探讨人工肝支持系统(Artificial liver support system,ALSS)在原位肝移植围手术期对急慢性肝功能衰竭的作用。方法回顾性分析401医院2003-09～2006-03实施肝移植40例,其中5例在肝移植围手术期进行人工肝治疗的临床资料。结果本组5例中,4例为术前人工肝血浆置换,患者的血清胆红素降低,肝性脑病得以纠正,凝血功能有改善,均顺利过渡到肝移植手术,术后已生存17～25个月,目前肝功能正常。1例为肝移植术后2个月,发生顽固性高胆红素血症并发感染,经4次人工肝治疗,延缓了肝衰竭的进程,接受了胆管造影,胆管支架置入引流,终因移植肝的功能衰竭,未能再次肝移植,术后5个月病死。结论AISS能纠正肝衰竭患者术前代谢紊乱,改善机体的内环境,为患者等待供肝,提高耐受肝移植手术创造条件,可减少手术风险。也能为术后肝功能提供有力支持,争取再次肝移植的机会。     

门冬氨酸鸟氨酸对肝切除术后肝功能保护作用的研究

Objective To investigate the protective effects of L-Ornithine-L-Aspartate on liver function in patients after liver resection. Methods Eighty-two patients undergoing liver resection were randomly divided into study group and control group. Control group was treated with conventional therapy and study group had conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the seven day after operation. The fasting alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), γ-glutamyl transpeptadase(GGT), total bilirubin(TB), direct bilirubin(DB) and blood ammonia(BA) levels were determined before operation and on days 1, 3 and 7 after operation. Results On days 1, 3 and 7 after operation, ALT and AST levels in the study group [ALT: ( 115.58 ± 69. 20), (81. 36 ± 14. 55 ), ( 61.24 ± 11. 32) U/L; AST: ( 127.29 ±33.61 ), (95.26 ± 16.83 ), (55.16 ± 14.83 )U/L] were significantly lower than those in the control group[ALT:(175.27 ±68.35), (97.37 ±34.24), (78.28 ± 19. 73) U/L;AST: (152. 29 ±31.65), (115.28 ±35.24),(82.49 ± 28.18) U/L] (P ＜ 0.05 ). In the study group of the porta blocked over 15 min, levels of AST, ALT were obviously lower than that of the control group( P ＜ 0. 05 ). Conclusions L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy, especially in the long time of porta blocked and has protective advantage for liver function.     

单纯端-端吻合的胆道重建对于肝移植术后早期肝功能恢复的观察

为比较肝移植术单纯端-端吻合胆道与术中放置T管的胆道重建方式对于术后早期肝功能的影响,将所选实验对象分为两组对比术后6个时相点ALT、TBIL、ALP、GGT水平,并经统计学处理分析。结果单纯端-端吻合胆道（不留置T管）的胆道重建对于术后早期肝功能的恢复略优于放置T管的常规术式。     

实验性脂肪性肝病大鼠肝细胞凋亡与组织病理的对比研究

目的研究细胞凋亡在实验性脂肪性肝病大鼠病理机制中的作用。方法40只Wister大鼠随机分为正常对照组(A组)、酒精组(B组)、高脂组(C组)和酒精加高脂(D组)四组,每组10只大鼠。16周断头处死,取肝组织标本,分别以HE、SudanⅣ、Masson三色染色观察肝组织光镜下的病理改变,进行量化评定,同时在电镜下观察其超微结构的变化。用TUNEI。法观察各组大鼠肝细胞凋亡的发生及其程度,并与肝组织病理改变进行对比分析。结果模型组大鼠肝组织均表现有不同程度的脂肪变性、炎症、坏死和纤维化,以D组病理损害最重。各模型组大鼠肝细胞凋亡指数明显增高,尤以D组最为明显,模型组肝细胞凋亡指数与肝组织炎症评分、纤维化程度正相关,与其脂变程度无关。结论不论是酒精或是高脂所致的脂肪性肝病大鼠,其肝细胞凋亡显著增加,并与肝组织炎症、坏死和纤维化改变正相关。说明肝细胞凋亡是脂肪性肝病病理变化的重要机制之一。     

生物人工肝应用及开发

人工肝可改善机体内环境，临床有望用于辅助治疗肝功能不全、肝衰竭以及相关肝脏疾病。生物人工肝是临床应用的发展方向。本文简要介绍生物人工肝的应用和注册进展，分析目前生物人工肝存在的问题并探讨其应用前景。     

Correlation of endothelium-dependent and -independent vasodilatation with liver function tests during prolonged perfusion of the rat liver

Twelve male Wistar rats were anaesthetized with pentobarbitone (3 mg 100g⁻¹ i.p.), the livers were excised and perfused in vitro through the hepatic artery and portal vein at constant flow rates of 0.32 ± 0.01 (mean ± S.E.) and 0.98 ± 0.03 ml min⁻¹ g liver⁻¹, respectively. The tone of the preparation was raised by methoxamine (7.5×10⁻⁶ M). Responses to mid-range doses of acetylcholine (−11 log mol) and sodium nitroprusside (−9 log mol) produced submaximal degrees of vasodilatation (−log mol ED₅₀ = 12.18 ± 0.08) and (−log mol ED₅₀ = 9.95 ± 0.23), respectively, which did not subside until 5.5 h of perfusion. These did not coincide with the increase in activities of lactic acid dehydrogenase (LDH) and aspartate serine transaminase (AST) activity at 2.5 h, which were indicative of hepatocellular mitochondrial and cytoplasmic damage, respectively. Vascular responses suggested that there was little deterioration in endothelial or smooth muscle function in the hepatic artery up to 5 h perfusion. This model can be reliably used to investigate endothelium-dependent and -independent vasodilators in vascular pharmacological studies of the rat liver although some minimal increases may occur in AST and LDH activity before hemodynamic changes appear at 5.5 h.