瑞舒伐他汀对急性冠脉综合征患者血脂与CRP的影响及疗效观察

目的：探讨瑞舒伐他汀对急性冠脉综合征(ACS)患者血脂与CRP的影响及疗效。方法纳入2012年1月至2015年1月来我院就诊的ACS患者90例,随机分为观察组和对照组,每组45例,给予观察组瑞舒伐他汀治疗,给予对照组阿托伐他汀治疗,均治疗28d。治疗前后检测并比较两组患者血脂包括TG、TC、HDL、LDL和hs-CRP水平,并观察两组治疗后临床疗效及不良反应发生情况。结果两组治疗后较治疗前TG、TC、LDL及hs-CRP水平均显著降低(P＜0.05);与对照组比较,治疗后观察组TG、LDL、hs-CRP水平分别为(1.40±0.17)mmol/L、(2.60±0.49)mmol/L、(6.46±2.01)mg/L显著较低(P＜0.05);治疗后观察组LDL达标率为82.22%、hs-CRP达标率为88.89%均显著高于对照组(P＜0.05);观察组治疗总有效率为91.11%显著高于对照组75.56%,且不良反应发生率为6.67%显著低于对照组24.44%(P＜0.05)。结论与阿托伐他汀治疗相比,瑞舒伐他汀对ACS患者血脂及CRP的改善效果更明显,疗效更显著且可极大降低不良反应发生率,安全性更高。     

Lower sperm quality and testicular and epididymal structural impairment in adult rats exposed to rosuvastatin during prepuberty

The increase of obesity, bad eating habits and the lack of physical exercises are highly related to dyslipidemias. Rosuvastatin is a lipid‐lowering drug and has been indicated to prevent cardiovascular diseases and to treat dyslipidemias due to its higher efficiency to reduce serum cholesterol concentrations. This study aimed to evaluate the reproductive adverse effects on sexual maturity due to rosuvastatin exposure in juvenile male rats during prepuberty. Three groups were randomly formed with newly weaned rats: control, whose rats received saline solution 0.9% and rosuvastatin at doses of 3 or 10 mg kg^–1 day^–1, administered orally by gavage, from postnatal day 21 until preputial separation (average of 45 days for controls and 49 days for statin‐treated animals), indicative of puberty onset. Male rats were maintained until sexual maturity and were killed on postnatal day 110. In the rosuvastatin‐treated groups, the results showed diminished follicle‐stimulating hormone, luteinizing hormone and testosterone concentrations, increased estradiol and prolactin concentrations, histopathologic alterations on testis and epididymis and decreased sperm quality. Moreover, statin‐exposed groups showed decreased expression of androgen receptor on testis and epididymis and lower expression of aquaporin‐9 on epididymal epithelium. In conclusion, administration of rosuvastatin to prepubertal male rats provoked long‐term hormonal deregulation and impaired reproduction at adulthood.     

高效液相色谱法测定瑞舒伐他汀钙片的含量

目的：探讨高效液相色谱法测定瑞舒伐他汀钙片的含量的准确性。方法采用高效液相色谱法分别对三种批号的瑞舒伐他汀钙片进行测定,250 mm＆#215;4.6 mm,5μm色谱柱;流动相（46：54）,0.2％三乙胺水溶液-乙腈,波长调至242 nm。结果瑞舒伐他汀钙片在浓度5.1～255μg/mL范围内,r＝0.9999,为良好线性关系。分别测得瑞舒伐他汀钙片含量为94.53%、95.76%、95.29%,RDS为0.59%、0.31%、0.11%。结论高效液相色谱法检测瑞舒伐他汀钙片含量,具有稳定性、准确性及重复性,值得推广应用。     

瑞舒伐他汀对2型糖尿病患者脂代谢紊乱治疗的临床观察

目的观察瑞舒伐他汀对2型糖尿病患者合并脂代谢紊乱治疗的疗效与安全性。方法对38例2型糖尿病合并脂代谢紊乱患者进行为期8周的瑞舒伐他汀治疗,并比较治疗前、治疗后的TC、TG、HDL-C、LDL-C等指标的变化,分析其对2型糖尿病合并脂代谢紊乱各组分的疗效及安全性。结果经瑞舒伐他汀治疗8周后,与治疗前相比,TC、TG、LDL-C水平均分别下降（21.50±19.75）%、（39.20±20.50）%、（16.98±33.18）%（P〈0.01或P〈0.05）,而HDL-C则升高（14.20±20.71）%（P〈0.05）。治疗期间,除1例ALT轻度升高外,无咽炎、肌痛、头痛和肝肾功能损害等不良反应发生。结论瑞舒代他汀能较好地纠正2型糖尿病患者合并的血脂代谢紊乱,尤其是TC、TG、LDL-C的降低效果明显,且安全性良好。     

双丹胶囊联合瑞舒伐他汀钙片治疗冠心病的临床观察

目的分析研究双丹胶囊联合瑞舒伐他汀钙片治疗冠心病的临床效果。方法采用随机数字表法将52例冠心病患者分成两组,每组26例,实验组予双丹胶囊联合瑞舒伐他汀钙片治疗,对照组予瑞舒伐他汀钙片治疗,比较并观察两组患者治疗后所取得的临床效果。结果两组患者经治疗后,实验组总有效率（92.31%）明显高于对照组总有效率（61.54%）,差异有统计学意义（P〈0.05）。实验组心血管事件发生率（3.85%）明显低于对照组心血管事件发生率（30.77%）,差异有统计学意义（P〈0.05）。两组患者治疗3个月后,实验组复发率（3.85%）明显低于对照组复发率（19.23%）,差异有统计学意义（P〈0.05）。结论双丹胶囊联合瑞舒伐他汀钙片治疗冠心病,可以有效控制患者的症状,并使疗效长时间保持,减少了不良反应的发生及复发,安全可靠,在临床上可以广泛运用。     

不同剂量瑞舒伐他汀治疗老年冠心病合并高脂血症的临床研究

目的探讨不同剂量瑞舒伐他汀治疗老年冠心病合并高脂血症的临床疗效。方法选取2011年7月—2013年12月来都江堰市中医医院就诊的老年冠心病合并高脂血症患者240例,随机分为辛伐他汀组,瑞舒伐他汀大、中、小剂量组,每组60例。辛伐他汀组患者晚餐后口服辛伐他汀片,20 mg/次,1次/d。瑞舒伐他汀大、中、小剂量组患者分别口服瑞舒伐他汀钙片20、10、5 mg/次,1次/d。两组均连续治疗6个月。观察各组的临床疗效,同时比较4组治疗前后总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、颈动脉斑块的面积、颈内膜–中膜的厚度。结果治疗后,辛伐他汀组和瑞舒伐他汀大、中、小剂量组总有效率分别为63.33%、91.67%、76.67%、68.33%,大、中、小剂量组患者的总有效率明显高于辛伐他汀组;大剂量组的总有效率明显高于中、小剂量组,差异有统计学意义(P0.05)。治疗后,4组患者TG、TC、LDL、颈动脉斑块面积和颈内膜–中膜厚度均显著降低,HDL显著升高,同组治疗前后差异有统计学意义(P0.05);且大、中剂量组的改善程度优于辛伐他汀组,大剂量组的改善程度优于中、小剂量组,差异有统计学意义(P0.05)。结论瑞舒伐他汀治疗老年冠心病合并高脂血症患者具有较好的疗效,可有效改善患者的血脂水平,尤其是大剂量组疗效更佳。     

Ezetimibe and Rosuvastatin Combination Treatment Can Reduce the Dose of Rosuvastatin Without Compromising Its Lipid-lowering Efficacy

PurposeThe goal of this study was to compare the lipid-lowering efficacy of the combination of ezetimibe and low- or intermediate-intensity statin therapy versus that of high-intensity statin monotherapy.MethodsThis study is a post hoc analysis of an 8-week, randomized, double-blind, Phase III trial. Patients who had hypercholesterolemia and required lipid-lowering treatment were randomly assigned to 1 of 6 treatment groups: rosuvastatin 5 mg (R5, n = 68), rosuvastatin 10 mg (R10, n = 67), rosuvastatin 20 mg (R20, n = 69), and ezetimibe 10 mg combined with rosuvastatin 5 mg (R5 + E10, n = 67), rosuvastatin 10 mg (R10 + E10, n = 68), and rosuvastatin 20 mg (R20 + E10, n = 68) daily. The effects of coadministration of ezetimibe and a low dose of rosuvastatin on lipid parameters and the target achievement rate were compared between the R5 + E10 and R10 treatment groups, the R5 + E10 and R20 treatment groups, and the R10 + E10 and R20 treatment groups.FindingsReductions in total cholesterol, LDL-C, apolipoprotein B, the apolipoprotein B/A1 ratio, and non–HDL-C were not different between the R5 + E10 and R10 treatment groups (all, P > 0.017), the R5 + E10 and R20 treatment groups (all, P > 0.017), and the R10 + E10 and R20 treatment groups (all, P > 0.017). R5 + E10 treatment showed efficacy comparable to that of R10 or R20 in affording LDL levels <50% of the baseline level (R5 + E10 vs R10, 73.13% vs 62.69% [P = 0.1952]; R5 + E10 vs R20, 73.13% vs 73.91% [P = 0.9180]), LDL-C levels <70 mg/dL (R5 + E10 vs R10, 64.18% vs 55.22% [P = 0.2906]; R5 + E10 vs R20, 64.18% vs 62.32% [P = 0.8220]), and LDL-C levels <50% of the baseline level or <70 mg/dL (R5 + E10 vs R10, 77.61% vs 70.15% [P = 0.3255]; R5 + E10 vs R20, 77.61% vs 78.26% [P = 0.9273]). The R10 + E10 treatment group was better than the R20 treatment group in achieving the target LDL-C level <70 mg/dL (83.82% vs 62.32%; P = 0.0046), even among participants with a baseline LDL-C level >135 mg/dL (77.5% vs 48.8%, respectively; P = 0.0074).ImplicationsEzetimibe combined with low- or intermediate-intensity statin therapy has lipid-lowering efficacy comparable to or better than that of high-intensity rosuvastatin monotherapy. The results of the present study indicate that the combination treatment with ezetimibe is advantageous in that it permits dose reduction of rosuvastatin without compromising the lipid-lowering efficacy of rosuvastatin. ClinicalTrials.gov identifier: NCT02205606.     

瑞舒伐他汀对原发性高胆固醇血症患者高敏C反应蛋白和红细胞分布宽度的影响

目的 探讨原发性高胆固醇血症患者高敏C反应蛋白（hs-CRP）和红细胞分布宽度（RDW）的关系及瑞舒伐他汀对其的影响.方法 分别采用免疫比浊法和全自动血细胞分析仪测定136例高脂血症患者的血清hs-CRP和RDW,并与80例正常人进行对照.原发性高胆固醇血症患者口服瑞舒伐他汀10 mg,1次/日.在治疗1个月、3个月和6个月后复查血脂、hs-CRP和RDW.结果 原发性高胆固醇血症患者血清hs-CRP含量显著高于正常对照组,RDW也明显高于正常对照组.瑞舒伐他汀治疗1个月后,血清hs-CRP浓度显著降低,治疗3个月后RDW也显著降低.结论 原发性高胆固醇血症患者血清hs-CRP浓度和RDW均升高,采用瑞舒伐他汀治疗显著降低了hs-CRP,同时也显著降低了RDW.     

鼠神经生长因子联合瑞舒伐他汀治疗老年糖尿病周围神经病变临床观察

目的观察和评价鼠神经生长因子(mNGF)联合瑞舒伐他汀治疗糖尿病周围神经病变(DPN)的疗效。方法67例老年DPN患者随机分为3组A组(n=23)给予甲钴胺治疗,B组(n=22)给予甲钴胺+鼠神经生长因子治疗,C组(n=22)给予甲钴胺+鼠神经生长因子+瑞舒伐他汀治疗,共4周;观察各组患者治疗前后的多伦多神经症状评分(TCSS)、神经传导速度(NCV)以及肝功能和血脂变化。结果3组治疗后均取得TCSS下降和NCV增加的显著改善(P<0.05),其中C组较A、B组改善程度更优,差异具有统计学意义(P<0.05)。结论联合使用mNGF和瑞舒伐他汀治疗老年DPN可能获得显著疗效。