他汀类药物治疗肾脏疾病研究进展

他汀类药物具有多方面的药理作用，在肾脏疾病中广泛应用，具有保护肾小球、肾小管，减少肾移植排异反应，降低晚期肾脏疾病(ESRD)病人冠心病发病率和死亡率等作用。     

他汀类药物治疗肾脏疾病研究进展

他汀类药物具有多方面的药理作用,在肾脏疾病中广泛应用,具有保护肾小球、肾小管,减少肾移植排异反应,降低晚期肾脏疾病(ESRD)病人冠心病发病率和死亡率等作用.     

他汀类药物对慢性阻塞性肺疾病患者的益处

他汀类药物--3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂,除了有降脂作用外,还有广泛的多效性,包括抗炎、抗氧化,抗凝、改善血管功能等作用.该药物的应用可以使慢性阻塞性肺疾病患者获益,本文将他汀类药物对慢性阻塞性肺疾病患者治疗的机制和效果作一综述.     

他汀类药物在防治慢性阻塞性肺疾病中的作用

他汀类药物是目前治疗高胆固醇血症的首选药物,近年来发现他汀类药物除降低胆固醇外,还具有抗炎、抗氧化、抗血栓形成和内皮细胞修复等作用,该类药物对慢性阻塞性肺疾病的防治作用已经过动物实验和临床研究的证实.     

慢性阻塞性肺疾病与他汀类药物

慢性阻塞性肺疾病的关键特征是气道、肺实质与全身的慢性炎症及进行性肺功能减退,他汀类药物是一种广泛用于治疗高脂血症与预防动脉粥样硬化的有效药物,近期研究提示,他汀类药物独立于降脂作用之外的多效性如抗炎、抗氧化、抗细胞凋亡和改善血管内皮功能等效应可能对慢性肺部炎症性疾病以及增强吸入性皮质激素抗炎效应、延缓慢性阻塞性肺疾病患...     

他汀类药物应用于慢性阻塞性肺疾病的研究进展

慢性阻塞性肺疾病(COPD)是一种具有气流受限特征,并且是进行性发展,不能完全可逆的疾病.目前COPD的药物治疗在改变患者疾病的预后方面作用有限.他汀类药物具有强有力的抗炎和免疫调节功能,有望成为降低COPD患者发病率及病死率的安全有效的药物.     

他汀类药物防治慢性心力衰竭的研究进展

他汀类药物目前已应用于冠心病的整体防治。随着研究深入,人们发现他汀类药物具有降血脂以外的心血管系统多效性作用(pleiotropic effects)对防治慢性心力衰竭(CHF)可能有效。本文将对他汀类药物防治CHF的作用机制、临床证据及当前存在的争议作一综述。     

他汀类药物在治疗慢性阻塞性肺疾病中的作用

近年来发现他汀类药物具有多效性,除了传统的降脂作用外,还包括抗炎、抗氧化、抗血栓和血管内皮细胞修复功能等,这些作用同样可以影响炎性气道疾病,他汀类药物在慢性阻塞性肺疾病中的治疗作用已经过许多研究的证实.     

他汀类药物在肾脏疾病治疗中的应用进展

他汀类药物是临床常用的调脂药物,对心血管保护作用明确,在预防和治疗肾脏疾病方面也逐渐得到共识。 他汀类药物作用于肾脏疾病的机制既有其降脂作用,也有其非降脂作用参与。部分研究认为他汀类药物具有肾脏 保护作用,可以降低蛋白尿、延缓肾小球滤过率(glomerular filtration rate,GFR) 下降等,但是不同的临床研究结论 仍存在争议。他汀类药物在肾脏疾病中的应用有广阔的前景。     

他汀类药物在慢性肾脏病患者中的应用

目前,慢性肾脏病(CKD)已经成为威胁全球人类健康的重大疾病之一,中国CKD的患病率约10.8％.既往研究显示,CKD患者心血管疾病的发病率和死亡率很高,而血脂异常作为CKD患者心血管疾病的一个独立危险因素,与肾脏疾病密切相关.脂代谢紊乱既是CKD的一种伴随的生化改变,也是CKD发生发展的始动因素.     

Managing dyslipidemia in chronic kidney disease

The incidence of chronic kidney disease (CKD) in the U.S. continues to increase, and now over 10% of the U.S. population has some form of CKD. Although some patients with CKD will ultimately develop renal failure, most patients with CKD will die of cardiovascular disease before dialysis becomes necessary. Patients with CKD have major proatherogenic lipid abnormalities that are treatable with readily available therapies. The severe derangements seen in lipoprotein metabolism in patients with CKD typically results in high triglycerides and low high-density lipoprotein (HDL) cholesterol. Because of the prevalence of triglyceride disorders in patients with CKD, after treating patients to a low-density lipoprotein goal, non-HDL should be calculated and used as the secondary goal of treatment. A review of the evidence from subgroup analysis of several landmark lipid-lowering trials supports treating dyslipidemia in mild to moderate CKD patients with HMG-CoA reductase inhibitors. The evidence to support treating dyslipidemia in hemodialysis patients, however, has been mixed, with several outcome trials pending. Patients with CKD frequently have mixed dyslipidemia and often require treatment with multiple lipid-lowering drugs. Although statins are the cornerstone of therapy for most patients with CKD, differences in their pharmacokinetic properties give some statins a safety advantage in patients with advanced CKD. Although most other lipid-lowering agents can be used safely with statins in combination therapy in patients with CKD, the fibrates are renally metabolized and require both adjustments in dose and very careful monitoring due to the increased risk of rhabdomyolysis. After reviewing the safety and dose alterations required in managing dyslipidemia in patients with CKD, a practical treatment algorithm is proposed.     

慢性肾脏病脂质异常的治疗及意义

血脂异常是慢性肾脏病患者的常见表现,它与慢性肾脏病的进展互为因果,共同参与慢性肾脏病高发心血管并发症和病死率。治疗中除了生活方式改变,强调他汀类药物治疗在慢性肾脏病患者血脂异常的早期治疗,副反应较一般人群无明显增加。已经看到他汀类药物治疗能够降低慢性肾脏病患者高发心血管事件和全因病死率,对降低尿蛋白和延缓肾脏病进展的益处还需要更多证据来证实。     

他汀类药物预防缺血性脑血管病的研究进展

他汀类药物（以下简称他汀类）因具有降脂作用，早在20世纪80年代就被应用于临床。它是3-羟基-3-甲基戊二酸单酰辅酶A（HMG—CoA）还原酶的抑制剂，主要通过竞争性抑制HMG—CoA还原酶而减少甲羟戊酸和其他甲羟戊酸通路的中间产物生成。以往用于临床的主要目的是降低血脂，尤其是降低胆固醇。迄今为止，很多基础研究和临床试验证实，他汀类在心血管病事件一级和二级预防中有显著作用。其中，大样本多中心随机对照试验4S试验和胆固醇与复发性血管事件研究（CARE）试验证实，他汀类对心血管疾病有预防作用的同时，对卒中也有积极的预防作用。     

The role of statins in chronic kidney disease

Chronic kidney disease is associated with cardiovascular event rates that are at least as high as in patients with established atherosclerotic cardiovascular disease or in those with diabetes mellitus. Chronic kidney disease is therefore considered a cardiovascular disease risk equivalent. Treatment of dyslipidemia, which is very common in this population and reflects the pattern seen in the metabolic syndrome, reduces cardiovascular events in patients with chronic kidney disease. Thus, patients with chronic kidney disease should be evaluated and treated for dyslipidemia. Dyslipidemia is a risk factor for the development of impaired kidney function. Dyslipidemia is also associated with progressive renal disease in subjects with no overt renal disease, as well as those with diabetic and nondiabetic kidney disease. Although definitive randomized controlled trials are lacking, the collective evidence suggests that treatment of dyslipidemia is associated with less decline in renal function. The use of potent statins in high doses can lead to transient proteinuria via impairment of proximal tubular receptor--mediated endocytosis, in a dose-dependent manner. Over the long term, however, the use of statins results in a reduction in proteinuria and in the rate of decline of renal function. Several large definitive trials that are currently underway to examine the safety and efficacy of statins in cardiovascular and renal protection should provide more definitive answers on the role of these drugs in this very high risk population.     

Hypertension and chronic kidney diseases

Chronic kidney diseases – arising from inborn or acquired renal disorders – are one of the most common causes of secondary hypertension. Renal parenchymatous hypertension accompanying bilateral or unilateral kidney diseases is more prevalent than renovascular hypertension. The prevalence and severity of hypertension are influenced by age, weight, type of renal affliction, and depth of renal dysfunction. In multifactorial pathogenesis, sodium retention plays the crucial role together with dysbalance concerning effects of different vasoactive substances; however, unequivocal distinction between volume- and renin-type hypertension is difficult. The treatment of renal hypertension includes appropriate lifestyle changes, pharmacotherapy, hemoelimination methods and radiological or urological invasive procedures. In chronic kidney diseases with increased albuminuria or proteinuria, ACE inhibitors and AT1-blockers are preferred. Combination of several antihypertensives is often required to achieve the target blood pressure. Increased blood pressure represents not only the manifestation of chronic kidney diseases but also an important factor concerning the renal and cardiovascular risk.     

他汀类药物在糖尿病心血管疾病防治中的作用

糖尿病是目前危害人类健康的主要疾病之一,大血管疾病并发症是糖尿病患者的主要死因,近80％的糖尿病患者死于心血管疾病。糖尿病人群的心血管病死亡率至少是普通人群的2～3倍。单纯糖尿病患者10年内发生心肌梗死或冠状动脉（冠脉）疾病死亡的危险性与陈旧性心肌梗死患者相当：且糖尿病患者发生急性心肌梗死的近期和远期预后较非糖尿病者差。为此．美国胆固醇教育计划（NCEP）成人治疗组第3次指南（ATPⅢ）中,明确将糖尿病视为冠心病等危症,并主张对糖尿病患者进行积极的降脂治疗。     

他汀类药物对慢性肝脏疾病进展及预后的影响

慢性肝病严重时可进展为肝纤维化和肝硬化,进而引起门静脉高压,最终可能发展至肝细胞癌。近年来,越来越多的研究发现他汀类药物可以使非酒精性脂肪性肝病患者的肝脏组织学得到改善,延缓肝纤维化进展,降低失代偿事件以及肝细胞癌的发生风险。介绍了他汀类药物在慢性肝病患者中的应用进展,为慢性肝脏疾病的防治提供一定的依据。