瑞舒伐他汀在高龄老年高胆固醇血症患者的应用

目的:评价瑞舒伐他汀治疗老年人高胆固醇血症的疗效及安全性。方法:对62例老年高胆固醇血症患者使用瑞舒伐他汀治疗,比较治疗前后血脂、肝功、肌酸磷酸肌酶、肌酐等的变化。结果:老年高胆固醇血症患者使用瑞舒伐他汀治疗2周后,总胆固醇[TC(5.58±1.11)mmol/L:(6.39±1.10)mmol/L]、低密度脂蛋白胆固醇水平[LDL-C(3.12±0.87)mmol/L:(4.22±0.91)mmol/L]较治疗前明显下降(P均0.05);12周后,TC[(4.59±0.99)mmol/L:(6.39±1.10)mmol/L]、甘油三酯[(1.76±0.70)mmol/L:(2.20±0.78)mmol/L]、LDL-C水平[(2.30±0.78)mmol/L:(4.22±0.91)mmol/L]较治疗前明显下降(P均0.05~0.01),高密度脂蛋白胆固醇较治疗前明显升高[(1.28±0.25)mmol/L:(1.09±0.21)mmol/L,P0.01]。所有患者对瑞舒伐他汀有良好耐受及很好的服药依从性,未发现药物相关的严重不良反应。结论:瑞舒伐他汀能全面改善老年高胆固醇血症患者血脂水平,并有良好的安全性。     

瑞舒伐他汀治疗老年冠心病伴高胆固醇血症患者的疗效

<正>冠心病(CHD)是临床中较为常见的多发病症之一,老年患者因其自身机体功能退化而成为CHD最主要的患者群体,高血脂和高胆固醇更是影响临床CHD治疗的关键因素〔1〕。因此,提升治疗的有效性与安全性,降低并发症的发生率,是治疗老年CHD伴高胆固醇血症患者的关键。高胆固醇血症是CHD最常见的伴发症,同时高胆固醇血症也是CHD的重要诱因之一〔2〕,因此有效控制血脂对于CHD的防治尤为重要。早期发     

瑞舒伐他汀与辛伐他汀治疗老年冠心病伴高胆固醇血症患者的疗效

高胆固醇血症,主要是指血胆固醇(TC)和(或)甘油三酯(TG)升高,属于人体脂肪代谢异常,是导致心血管疾病最重要的危险因素之一。研究资料表明,高胆固醇血症是心脏猝死、心肌梗死、冠心病、脑卒中独立而重要的危险因素。本文以老年冠心病合并高胆固醇血症患者为研究对象,分析两组患者血脂变化及降脂治疗的不良反应。     

瑞舒伐他汀与辛伐他汀治疗老年冠心病伴高胆固醇血症的临床对比

目的比较瑞舒伐他汀与辛伐他汀治疗老年冠心病伴高胆固醇血症的临床疗效及安全性。方法老年冠心病伴高胆固醇血症患者132例,按随机数字法分为观察组和对照组,各66例,观察组予以瑞舒伐他汀治疗,对照组予以辛伐他汀治疗,比较两组患者治疗后的血脂水平、颈动脉斑块面积及药物不良反应发生情况。结果观察组患者治疗后低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)明显低于对照组(P0.05),但两组患者治疗后甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)无明显差异(P0.05)。观察组患者治疗后颈动脉斑块面积、颈动脉内膜-中膜厚度较治疗前及对照组治疗后明显降低(P0.05)。观察组不良反应发生率为6.06%,远低于对照组的18.18%(P0.05)。结论瑞舒伐他汀治疗老年冠心病伴高胆固醇血症患者降脂效果显著,安全性高。     

氟伐他汀对高胆固醇血症患者载脂蛋白的影响

近年来的研究表明,高胆固醇血症是发生动脉粥样硬化的重要因素,其中载脂蛋白 A Ⅰ(ApoA Ⅰ)和载脂蛋白B(ApoB)与动脉粥样硬化密切相关。而他汀类调脂药物被广泛应用于临床治疗高胆固醇血症。本研究旨在观察氟伐他汀对原发性高胆固醇血症患者载脂蛋白的作用。1 资料与方法1.1 对象1998-2002年在我院就诊的原发性高胆固醇血症患者,经高脂血症膳食控制方案[1]饮食控制2周后血清总胆固醇(TC)≥5.98mmol/L的未     

阿托伐他汀治疗老年高胆固醇血症患者对胰岛素抵抗的影响

一、对象与方法　　 1.对象 :2 0 0 1年 11月至 2 0 0 2年 1月我院二内科住院的老年患者 36例 ,男 2 8例 ,女 8例 ,年龄 6 0～ 75岁 ,平均6 4 8岁。其中高胆固醇血症〔总胆固醇 (ＴＣ)≥ 5 7ｍｍｏｌ/Ｌ〕患者 13例 ,混合型高脂血症〔ＴＣ≥ 5 7ｍｍｏｌ/Ｌ、甘油三酯 (ＴＧ)≥ 1 7ｍｍｏｌ/Ｌ〕患者 2 3例 ,排除冠心病、高血压、甲状腺疾病、糖尿病、慢性胰腺炎、肝肾疾病 ,所有患者治疗前2个月均未进行降脂治疗。　　 0 2 .观察方法 :本组对象试验前均于早晨空腹 (禁食 12ｈ以上 )采静脉血化验 ,包括ＴＣ、ＴＧ、低密度脂蛋白胆固醇(Ｌ…     

氟伐他汀治疗原发性高胆固醇血症疗效观察

目的;探讨氟伐他汀治疗原发性高胆固醇血症的临床疗效,并观察其安全性。方法：43例高胆固醇血症给氟伐他汀20－40mg,1次／日,口服,比较服药前,后4周,8周血脂变化,结果：服药4周后血清胆固醇（TC）均值下降19．7％（P＜0．01）,甘油三酯（TG）下降11．6％（P＜0．05）,低密度脂蛋白胆固醇（LDL－C）下降24．8％（P＜0．01）,高密度脂蛋白胆固醇（HDL－C）升高4％（P＜0．05）,第8周与4周变化不大,结论：氟伐他汀能有效降低TC,LDL－C和TG,并能轻度升高HLD－C,保护冠状动脉,且安全,价廉,易于接受。     

他汀类药物对高胆固醇血症患者炎症因子和红细胞膜脂肪酸的影响

目的比较瑞舒伐他汀与辛伐他汀的调脂疗效及其对血液中炎症因子、红细胞膜上脂肪酸的影响。方法选择2005年6月至12月南昌大学医学院第二附属医院心内科门诊诊断的30例高胆固醇血症(HC)患者(LDL-C>3.64mmol/L)接受8周的双盲对照治疗,分别服用瑞舒伐他汀或辛伐他汀,开盲后按随机号每种药物选择15名患者。患者均于治疗前、治疗4周末及8周末采空腹静脉血测血脂4项、高敏C-反应蛋白(hs-CRP)、白介素-6。同时随机选择瑞舒伐他汀组中7例高胆固醇血症患者,另选7名血脂正常成人为对照,观察红细胞膜脂肪酸(FA)的构成比在治疗前后的变化。分别在治疗前与治疗4周末采血测定红细胞膜FA。结果(1)治疗4周末2组血清LDL-C、总胆固醇(TC)、hs-CRP水平均明显降低;治疗8周末LDL-C、TC未见进一步下降,但hs-CRP仍有进一步降低。(2)与对照组相比,高胆固醇血症组(HC)红细胞膜上饱和脂肪酸(SFA)所占比例明显更高,而多不饱和脂肪酸(PUFA)、ω-3脂肪酸比例明显较低。治疗4周后SFA明显降低,而PUFA、ω-3脂肪酸的比例明显增高。结论(1)2组药物降低炎症因子的作用是独立于调脂作用的。(2)瑞舒伐他汀10mg/d治疗能有效降低高胆固醇血症患者血清LDL-C与TC水平。其调脂效果与20mg/d辛伐他汀相似。(3)血脂异常影响红细胞膜上各类脂肪酸的含量及比例,2组药物均可有效改善HC患者红细胞膜上不同脂肪酸的构成比例。     

西立伐他汀治疗原发性高胆固醇血症随机对照研究

目的：比较不同剂量的西立伐他汀（ｃｅｒｉｖａｓｔａｔｉｎ）治疗国人原发性高胆固醇血症的疗效、安全性及耐受性。方法采用多中心,随机、双盲、安慰剂对照,平行组试验,所有入选停止其他降脂治疗且饮食控制达美国心脏协会Ⅰ级（ＡＨＡ－ＳＴＥＰ－Ｉ）或其相应标准,满４周后,接受单盲安慰剂治疗５周（Ａ期）。安慰剂期后,４７０例患随机接受西立伐他汀０．１ｍｇ（ｎ＝１１９）、０．２ｍｇ（ｎ＝１１７）、０．３ｍｇ（     

Fatty acids of erythrocyte membrane in acute pancreatitis patients

AIM:To evaluate changes in the fatty acid composition of erythrocyte membrane phospholipids during severe and mild acute pancreatitis(AP)of alcoholic and nonalcoholic etiology.METHODS:All consecutive patients with a diagnosis of AP and onset of the disease within the last 72 h admitted to the Hospital of Lithuanian University of Health Sciences between June and December 2007 were included.According to the Acute Physiology and ChronicHealth Evaluation(APACHEⅡ)scale,the patients were subdivided into the mild(APACHEⅡscore<7,n=22)and severe(APACHEⅡscore≥7,n=17)AP groups.Healthy individuals(n=26)were enrolled as controls.Blood samples were collected from patients on admission to the hospital.Fatty acids(FAs)were extracted from erythrocyte phospholipids and expressed as percentages of the total FAs present in the chromatogram.The concentrations of superoxide dismutase and glutathione peroxidase were measured in erythrocytes.RESULTS:We found an increase in the percentages of saturated and monounsaturated FAs,a decrease in the percentages of total polyunsaturated FAs(PUFAs)and n-3 PUFAs in erythrocyte membrane phospholipids of AP patients compared with healthy controls.Palmitic(C16:0),palmitoleic(C16:1n7cis),arachidonic(C20:4n6),docosahexaenoic(DHA,C22:6n3),and docosapentaenoic(DPA,C22:5n3)acids were the major contributing factors.A decrease in the peroxidation and unsaturation indexes in AP patients as well as the severe and mild AP groups as compared with controls was observed.The concentrations of antioxidant enzymes in the mild AP group were lower than in the control group.In severe AP of nonalcoholic etiology,the percentages of arachidic(C20:0)and arachidonic(C20:4n6)acids were decreased as compared with the control group.The patients with mild AP of nonalcoholic etiology had the increased percentages of total saturated FAs and gama linoleic acid(C18:3n6)and the decreased percentages of elaidic(C18:1n9t),eicosapentaenoic acid(EPA,C20:5n3),DPA(C22:5n3),DHA(C22:6n3)as well as total and n-3 PUFAs in erythro     

Evaluating the interaction of common FTO genetic variants,added sugar,and trans-fatty acid intakes in altering obesity phenotypes

Background and aims

The results of studies on the effect of trans-fatty acids (TFAs) and added sugars on obesity are not consistent. This study aimed to investigate whether the association of changes in general and central obesity with added sugar and TFA intakes is modified by common fat mass and obesity-associated gene (FTO) polymorphisms, in isolation or in a combined-form genetic risk score (GRS).

PPARα激活物影响HepG-2细胞PAI-1表达机制初探

目的探讨不同的过氧化体增殖物激活型受体α(PPARα)激活物对HepG-2细胞纤溶酶原激活物抑制剂-1(PAI-1)活性和mRNA表达的影响及其可能的机制。方法分别以亚油酸和非诺贝特刺激HepG-2细胞,检测PAI-1活性和mRNA表达。基因瞬时转染含不同片段缺失的PAI-1启动子序列控制表达的报告基因质粒,测定亚油酸和非诺贝特诱导后的转录活性。结果亚油酸使HepG-2细胞PAI-1 mRNA表达及蛋白活性显著增加,而非诺贝特使其著降低。转染HepG-2细胞由PAI-1启动子全长控制的表达质粒,亚油酸诱导PAI-1转录活性显著增加,非诺贝特显著抑制其转录活性;转染PAI-1启动子序列核转录因子KB(NF-KB)反应元件缺失的质粒时,亚油酸和非诺贝特仍显著增加PAI-1转录活性;而转染PAI-1启动子序列极低密度脂蛋白(VLDL)／脂肪酸反应元件缺失的质粒时,亚油酸对PAI-1转录活性无诱导作用,非诺贝特可下调其转录活性。结论PPARα可能是亚油酸增强PAI-1表达所涉及的转录因子之一;非诺贝特下调PAI-1表达可能涉及对NF-κB信号转导途径的抑制作用。     

红细胞膜脂肪酸成分、膜流动性改变与糖尿病视网膜病变的关系

目的探讨红细胞膜脂肪酸成分和膜流动性与糖尿病视网膜病变（ＤＲ）之间的关系。方法采用高效液相色谱法和荧光偏振技术测定２９例正常人和６３例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者红细胞膜脂肪酸成分和膜微粘度。结果ＮＩＤＤＭ病人红细胞膜花生四烯酸（Ｃ２０∶４ｎ－６）含量及百分组成明显低于正常对照组，而膜微粘度则明显高于对照组，且在伴有ＤＲ组其膜微粘度又明显高于不伴有ＤＲ组。患者膜微粘度与膜软脂酸（Ｃ１６∶０）和硬脂酸（Ｃ１８∶０）百分组成呈明显正相关，而与花生四烯酸和廿二碳六烯酸（Ｃ２２∶６ｎ－３）呈明显负相关。结论ＮＩＤＤＭ病人红细胞膜脂酸组成对其膜流动性降低有重要影响，而后者对ＮＩＤＤＭ微血管病变的发生和发展可能起重要作用。     

The effect of trans-resveratrol on platelet-neutrophil complex formation and neutrophil burst in hypercholesterolemic rats

Transresveratrol (t-resveratrol; 3,5,4′-trihydroxy-trans-stilbene) is a polyphenolic compound found in fresh grapes, grape juice and wine, and has been found to reduce the total cholesterol level in hypercholesterolemic rats. The objective of the present study was to assess the effects of t-resveratrol on platelet-neutrophil complex formation and neutrophil reactive oxygen species (ROS) status in control and hypercholesterolemic rats using a modified flow cytometric method. Rats (n=80) were divided into five groups (control, ethanol, resveratrol, hypercholesterolemic and resveratrol-administered hypercholesterolemic groups), comprising 16 animals per group. Serum levels of lipids and H₂O₂ were determined using commercially available kits, while platelet-neutrophil complex formation and neutrophil ROS status were determined using a modified flow cytometric method. Serum total cholesterol and low-density lipoprotein cholesterol levels were found to be increased and the high-density lipoprotein cholesterol level was found to be decreased in the HC group compared with the control group (P<0.001). Treatment of HC rats with t-resveratrol significantly lowered total cholesterol and low-density lipoprotein cholesterol levels (P<0.001). In the hypercholesterolemic group, levels of serum H₂O₂ platelet-neutrophil complex formation and neutrophil ROS status were significantly increased (P<0.001). On the other hand, in the resveratrol-administered hypercholesterolemic group, serum H₂O₂ levels, platelet-neutrophil complex formation and neutrophil ROS status were decreased compared with the hypercholesterolemic group (P<0.001). Serum H₂O₂ levels, platelet-neutrophil complex and neutrophil ROS status were positively correlated with one another. The present study is the first to demonstrate the protective effect of t-resveratrol against hypercholesterolemia-induced platelet-neutrophil complex formation and neutrophil ROS burst. Further investigations on its plausible role in antihypercholesterolemic treatment are warranted.     

非酒精性脂肪性肝病与血小板磷脂膜脂肪酸的相关性

非酒精性脂肪性肝病(NAFLD)是一类肝组织学改变与酒精性肝病相类似,但无过量饮酒史的临床综合征,以肝实质细胞脂肪变性和脂肪贮积为特征.     

曲美他嗪对慢性心衰患者心功能及血清游离脂肪酸的影响

目的：探讨盐酸曲美他嗪对慢性心力衰竭（CHF）患者心功能和血清游离脂肪酸（FFA）的影响。方法：120例CHF患者被随机分为曲美他嗪组（60例）和常规治疗组（60例）。曲美他嗪组在常规治疗的基础上再加用盐酸曲美他嗪（20mg口服,3次／d）,观察治疗前及治疗后三个月左室射血分数（LVEF）、左室短轴缩短率（Fs）、6min步行距离（6MWD）、血清游离脂肪酸（FFA）变化。结果：与治疗前比较,治疗后两组LVEF、FS均明显升高、6MWD明显增加,血清FFA浓度明显降低（P均d0．05）;与常规治疗组治疗后相比,曲美他嗪组LVEFr（0．46±0．03）比（0．48±0．03）3、FS[（O．24±0．03）比（0．25±0．04）]升高更明显,6MWD[（540±109）m比（560±122）m]明显增加,血清FFA[（0．47±0．04）mmol／L比（0．35±0．06）mmol／L]浓度更低（P均〈0．05）。结论：盐酸曲美他嗪有助于改善慢性心力衰竭患者的心功能,可能与降低血清游离脂肪酸水平有关。     

Soluble adhesion molecules and marine n-3 fatty acids in patients referred for coronary angiography

OBJECTIVE: To investigate the relationship between soluble cellular adhesion molecules (sCAMs) and the extent of coronary artery disease (CAD) in patients with stable angina pectoris. METHODS AND RESULTS: Two hundred and ninety-one subjects had fasting levels of circulating intercellular adhesion molecule-1(sICAM-1), vascular cellular adhesion molecule-1 (sVCAM-1), sP-selectin and contents of n-3 polyunsaturated fatty acids (n-3 PUFA) in granulocyte membranes and adipose tissue determined before undergoing elective coronary angiography. Levels of soluble VCAM-1 (983+/-216 versus 893+/-196 ng/l, p<0.001), ICAM-1 (318+/-140 versus 290+/-75 ng/l, p<0.05) and P-selectin (90+/-27 versus 80+/-23 ng/l, p<0.01) were significantly increased in subjects with significant CAD compared to subjects with no significant stenoses. In a linear regression analysis, both sVCAM-1 and sP-selectin, but not sICAM-1, correlated to the presence and the severity of CAD. Both sICAM-1 and sP-selectin were significantly correlated to current smoking status and a history of myocardial infarction. The content of total n-3 PUFA and docosahexaenoic acid in adipose tissue was marginally, but significant positively correlated to VCAM-1. CONCLUSION: sVCAM-1 and sP-selectin may serve as markers of CAD in patients with stable angina pectoris. Only sVCAM-1 was weakly correlated to n-3 PUFA in adipose tissue.     

2型糖尿病血管内皮功能的变化与他汀类药物的调节作用

内皮功能障碍在2型糖尿病（T2DM）患者并发症的发生和发展过程中起着非常重要的作用。高糖、血脂代谢异常、胰岛素抵抗等均能通过各种直接或间接途径如促炎症效应,内皮型一氧化氮（NO）合酶和NO活性改变,氧化应激,胰岛素介导的信号转导通路异常等导致内皮功能障碍,而他汀类药物可能通过影响这些途径从而在总体上调节T2DM患者的内皮功能。