他汀类药物治疗冠心病合并高脂血症的观察与研究

目的观察与研究他汀类药物治疗冠心病合并高脂血症的效果。方法选取符合条件的80例冠心病合并高脂血症患者且给予他汀类药物进行治疗,同时对其效果、心血管不良事件及患者生活质量等方面进行观察与相关数据统计和分析。结果他汀类药物能够明显改善患者血脂水平、降低心血管不良事件发生率以及能够改善患者生活质量(P<0.05),具有统计学意义。结论他汀类药物治疗冠心病合并高脂血症疗效确切。     

他汀类药物在冠心病慢性心力衰竭中的作用分析

目的观察与分析他汀类药物在冠心病慢性心力衰竭中的效果。方法选取符合条件的80例冠心病慢性心力衰竭者且将其分为两组,即常规治疗组和他汀类治疗组,同时对其治疗情况进行观察与相关数据统计分析。结果他汀类治疗组患者心功能得以明显改善且不良事件发生率低于常规治疗组(P<0.05)。结论他汀类药物在冠心病慢性心力衰竭患者中应用效果良好,有积极的防治作用。     

他汀类药物治疗冠状动脉粥样硬化性心脏病的护理体会

目的探讨他汀类药物在冠状动脉粥样硬化性心脏病(简称冠心病)临床治疗中的临床效果及护理要点。方法选择2011年5月至2012年5月122例冠心病患者,随机均分成治疗组和对照组,两组均给予冠心病常规治疗,治疗组在此基础上加用他汀类药物。结果对照组治疗前后的低密度脂蛋白、甘油三酯、血清总胆固醇无明显变化(P>0.05),治疗组治疗前后这3种指标差异具有统计学意义(P<0.05)。治疗组的不良事件发生率明显低于对照组(P<0.05)。结论他汀类药物改善了冠心病患者的血脂状况,也降低了冠心病不良事件发生率和死亡率。应在对冠心病患者做好各方面护理干预的前提下,积极有效地加强他汀类药物在冠心病治疗中的应用。     

他汀类药物对动脉粥样硬化的临床治疗体会

目的探讨他汀类药物在抗动脉继样硬化治疗效果。方法收集临床80例动脉粥样硬化患者行他汀类药物治疗资料进行分析。结果他汀类药物能显著降低Tc和LDC,也降低TG水平和轻度升高HDL。此外,他汀类药物可能具有抗炎、保护血管内皮和稳定斑块的作用,这可能与冠心病的减少有关。结论他汀类药物是当前防治高胆固醇血症和动脉粥样硬化性疾病非常重要的药物。     

他汀类药物对冠心病血管重建治疗的影响

冠心病血管重建治疗包括经皮冠状动脉腔内成形术(PTCA)和冠状动脉旁路移植术(CABG)。近20年来，这两项技术均迅速发展，成为冠心病血管重建治疗的重要手段。与此同时，他汀类药物降脂治疗在冠心病一级和二级预防中发挥了重要作用，是近年来冠心病治疗学发展的里程碑之一。有关他汀类药物对冠心病血管重建治疗的影响，主要从三方面进行探讨。     

他汀类药物对动脉粥样硬化的临床治疗体会

目的探讨他汀类药物在抗动脉继样硬化治疗效果。方法收集If缶床80例动脉粥样硬化患者行他汀类药物治疗资料进行分析。结果他汀类药物能显著降低TC和LDC,也降低TG水平和轻度升高HDL。此外,他汀类药物可能具有抗炎、保护血管内皮和稳定斑块的作用,这可能与冠心病的减少有关。结论他汀类药物是当前防治高胆固醇血症和动脉粥样硬化性疾病非常重要的药物。     

他汀的药物基因组学研究进展

他汀类药物在冠心病整体防治中起重要地位。某些候选基因的多态性可以预测他汀治疗的效果或不良反应,本文综述了药物基因组学研究在他汀类药物使用的进展,为他汀类药物的个体化使用提供参考依据。     

他汀类药物与冠心病的预防

目的观察他汀类药物预防冠心病的效果。方法选择300例冠心病患者长期服用他汀类药物，观察不同时期患者的血脂水平和心血管事件。结果与治疗前相比，他汀类药物能明显降低患者的TC与LDL-C、升高HDL-C水平，差异有统计学意义（P〈0．05）。结论他汀类药物在冠心病预防及治疗中有着重要地位，具有显著的调脂作用，能明显降低心血管事件的发生。     

他汀降胆固醇预防冠心病临床分析

目的 探讨他汀降胆固醇预防冠心病的临床效果.方法 对冠心病患者他汀类药物降胆固醇预防临床资料进行回顾性分析.结果 采用他汀类药物降脂治疗,以降低LDL-C,使其达到〈100 mg/dl（2.6 mmol/L）.TC、LDL、TG明显降低,及高密度脂蛋白升高.结论 他汀类药物能有效降低TC和LDL-C,还有延缓斑块进展,使斑块稳定和抗炎等调脂以外的作用.所有冠心病患者,无论其血脂水平如何,均应给予他汀类药物.     

11106 阿司匹林加他汀类药物治疗冠心病价效比更合理

美国研究者报道，有十年冠心病危险≥7．5％的男性应该使用阿司匹林，有十年冠心病危险≥10%的男性应该使用阿司匹林加他汀类药物。 研究者将已经发表的研究资料整合入Markov模型，估计花费和获益。分别观察阿司匹林治疗组，他汀类药物治疗组，联合他汀类药物和阿司匹林治疗组，无治疗组。患者为假设的年龄在45岁，10年冠心病危险为7．5%的健康男性。     

Statin mediated protection of the ischemic myocardium

Hypercholesterolemia is a major risk factor in the development of cardiovascular disease and HMG-CoA reductase inhibitors (i.e. statins) were originally designed to reduce serum cholesterol levels and thus reduce this risk factor. However, it has become increasingly apparent that the effects of statins extend well beyond their lipid lowering actions, and these pleiotropic effects have a major role in protecting the myocardium against ischemic injury. There have been a large number of clinical studies demonstrating the safety and efficacy of statins in reducing total mortality as well as many other secondary endpoint markers in patients with cardiovascular disease. In addition, statins appear to benefit patients with a variety of clinical conditions such as acute coronary syndromes and severe heart failure. Recent experimental studies demonstrated that stains can rapidly (i.e. within hours) upregulate endothelial nitric oxide synthase (eNOS) activity and nitric oxide (NO) production. These landmark studies of statins and eNOS function set the foundation for the investigation of the protective effects of statins. Many experimental studies investigating the effects of statins on eNOS and cardiac injury in the setting of ischemia and reperfusion have been performed in an attempt to determine the extent of the protection as well as the mechanism of the protection. This review article will focus on our current understanding of statin-mediated protection of the myocardium against ischemia-reperfusion injury and infarction.     

The Many Roles of Statins in Ischemic Stroke

Stroke is the third leading cause of human death. Endothelial dysfunction, thrombogenesis, inflammatory and oxidative stress damage, and angiogenesis play an important role in cerebral ischemic pathogenesis and represent a target for prevention and treatment. Statins have been found to improve endothelial function, modulate thrombogenesis, attenuate inflammatory and oxidative stress damage, and facilitate angiogenesis far beyond lowering cholesterol levels. Statins have also been proved to significantly decrease cardiovascular risk and to improve clinical outcome. Could statins be the new candidate agent for the prevention and therapy in ischemic stroke? In recent years, a vast expansion in the understanding of the pathophysiology of ischemic stroke and the pleiotropic effects of statins has occurred and clinical trials involving statins for the prevention and treatment of ischemic stroke have begun. These facts force us to revisit ischemic stroke and consider new strategies for prevention and treatment. Here, we survey the important developments in the non-lipid dependent pleiotropic effects and clinical effects of statins in ischemic stroke.     

PCSK9抑制剂在动脉粥样硬化性心血管疾病中的临床研究进展

动脉粥样硬化性心血管疾病(ASCVD)现已成为危害人类健康的主要疾病之一。降低胆固醇治疗尤其是低密度脂蛋白-胆固醇(LDL-C),是ASCVD防治的基石,目前指南推荐控制LDL-C水平首选他汀类药物。但在临床实践中,经过他汀治疗的ASCVD患者仍存在较高剩留风险,另仍有部分患者不能耐受他汀类药物或在他汀类药物最大耐受剂量的情况下血脂仍不能达标。人前蛋白转化酶枯草溶菌素9(PCSK9)与LDL-C代谢密切相关,近年来大量基础和临床研究均证实PCSK9抑制剂能够显著降低血LDL-C水平,且耐受性和安全性良好。目前国外已批准PCSK9抑制剂用于临床。本文将系统综述有关PCSK9基因与血脂代谢的关系、PCSK9抑制剂的研发过程,总结其在基础和临床研究的最新进展。     

他汀类药物代谢相关基因多态性与其不良反应发生的相关性

目的:为他汀类药物的临床精准用药,预防和减少不良反应(ADR)的发生提供参考。方法:收集近年来国内外有关他汀类药物基因多态性与其ADR的参考文献,对他汀类基因多态性与其ADR的相关性进行归纳和总结。结果:药物代谢酶和转运体的相关基因多态性是影响他汀类药物ADR发生的重要因素。结论:基因多态性研究可为预防他汀类药物的ADR提供参考依据,临床可在服用他汀类药物前对患者进行基因型检测,以降低ADR的发生率。     

Statins in the treatment of acute ischemic stroke

3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (also known as statins) are drugs active in the blockade of cholesterol synthesis and thus lowering cholesterol serum levels. Since their discovery, experimental evidence showed that statins strongly reduced atherogenesis and the risk of acute ischemic complications, such as acute myocardial infarction and stroke. More recently, direct anti-atherosclerotic effects of statins (independently of lipid profile improvement) have been also shown, suggesting new potential applications for these drugs in both primary and secondary prevention of acute cardiovascular events. Despite some controversies exist, the use of statins has been shown to improve both incidence and survival in acute ischemic stroke. The molecular mechanisms underlying statin-mediated clinical benefits were recently identified in the reduction of carotid plaque vulnerability and the increase of neuroprotection. In the present review, we will update evidence on the promising results with statins to improve ischemic stroke outcomes.     

他汀类药物的作用机制及应用研究进展

他汀药物是一类强有效的调脂药物,尤其是降低体内低密度脂蛋白胆固醇的水平,在动脉粥样硬化性心血管疾病的防治中具有不可替代的作用。近年来研究发现,他汀类药物还具有众多非降脂的药理效果,这使得他汀类药物的应用更加受到关注。本文将对近年有关他汀类药物的治疗多效性及研究进展进行综述。     

Lipid-lowering drug use in Italian primary care: effects of reimbursement criteria revision

Objective To assess whether the prescribing pattern of lipid-lowering drugs (LLD) changed after reimbursement criteria revision in a general practice in southern Italy. Methods From the Caserta-1 Local Health Service database, 93 general practitioners (GPs) who had consistently sent data about their patients during the years 2003-2005 were recruited. Prevalence of use and incidence of new treatments were calculated for each year, stratified by three drug cohorts: statins, omega-3 fatty acids, and fibrates. Subanalyses by gender, age, and indication of use were performed. Results Overall, 1-year prevalence of LLD use increased from 2003 to 2004. After reimbursement criteria revision (November 2004), a slight decrease was observed for statins, from 41.1 (95% CI: 39.9–42.2) per 1,000 inhabitants in 2004 to 40.3 (39.2–41.5) in 2005, while omega-3 utilization fell markedly: 14.6 (13.9–15.3) vs. 5.4 (5.0–5.8). The use of both statins and omega-3 fatty acids was reduced particularly for primary prevention. On the other hand, utilization of statins increased in diabetic patients and as secondary prevention from 2004 to 2005. Concerning individual molecules, 1-year prevalence of use of any statin declined from 2004 to 2005, except for rosuvastatin. Conclusions Revision of reimbursement criteria led to significant changes in the trend in LLD use in general practice in southern Italy: (1) statin utilization was slightly reduced in 2005, although it increased in certain categories, such as diabetic patients, and (2) omega-3 fatty acid use was strongly reduced even though a higher use in post-infarction cases was reported.     

Prescribing behaviour according to Dutch and European guidelines on the management of hypercholesterolaemia (1992-1999)

BACKGROUND: The success of the full implementation of a new guideline may depend on the observed discrepancy between daily medical practice developed before the release of the guideline and new treatment recommendations issued by the guideline. AIM: To assess whether the initiation of statin treatment for primary prevention of cardiovascular disease in an elderly population was in agreement with guidelines. METHODS: Data were obtained from the Rotterdam Study, a prospective population-based cohort study consisting of 7983 subjects aged>or=55 years. In the period 1992-1999, all patients starting statins for primary prevention were selected. Treatment eligibility was established according to Dutch guidelines based on considerations of cost effectiveness (1998) and European guidelines based on clinical effectiveness (1998 and 2003). RESULTS: Only 5.7% [95% confidence interval (CI) 3.1, 8.3] of the 299 subjects starting statins for primary prevention met the eligibility criteria of the Dutch guidelines. Most patients (92.0%, 95% CI 88.9, 95.1) met the criteria of the 2003 European guidelines. Patients who did not meet any eligibility criteria were female and had one or less cardiovascular risk factor, except for two patients with total cholesterol levels<5 mmol l-1 prior to start of statin therapy. CONCLUSIONS: The use of statins was in agreement with the most recent European guidelines in over 90% of elderly patients who started statins for primary prevention, but in only 6% of these patients according to the Dutch guidelines. As long as existing guidelines are as discrepant as they are now, variation in agreement between physicians' prescribing and guideline recommendations is unavoidable.