吲达帕胺缓释片单独或联合阿托伐他汀治疗老年单纯收缩期高血压的疗效比较

目的比较吲达帕胺缓释片单独或联合阿托伐他汀治疗老年单纯收缩期高血压降压效果的差异。方法随机、单盲、阳性药物对照平行研究。选取血脂正常老年单纯收缩期高血压患者81例,随机单盲分为两组:吲达帕胺治疗组(A组,40例),每日口服钠催离1.5mg;吲达帕胺联合阿托伐他汀治疗组(B组,41例),每日口服钠催离1.5mg和立普妥10mg。两组均经2周安慰剂洗脱期后进入治疗,随访8周。观察肝肾功能、电解质、血脂、血压的变化。结果A组和B组的高血压治疗达标率分别为73%和78%,两组对比无显著性差异,分别降低收缩压27.8mmHg和33.0mmHg,组内前后对比呈高度显著性差异(P<0.01)。两组的降压值相比,B组可额外降低收缩压5.2mmHg,具有显著性意义(P<0.05)。结论B组较A组可进一步降低血压。阿托伐他汀可能存在一定程度的降压作用。     

阿托伐他汀钙治疗慢性充血性心力衰竭100例

目的评价阿托伐他汀钙治疗慢性充血性心力衰竭的疗效。方法将200例慢性充血性心力衰竭患者随机分为对照组和观察组。对照组给予常规治疗，观察组在对照组的基础上加用阿托伐他汀钙。结果观察组总有效率89．00％高于对照组的71．00％，差异具有高度统计学意义（P〈0．01）。观察组LVEF、步行运动耐量优于对照组，差异具有高度统计学意义（P〈0．01）。两组均未出现严重药物不良反应事件。结论阿托伐他汀钙治疗慢性充血性心力衰竭患者疗效可靠，副作用小。     

阿托伐他汀对老年高血压患者血管内皮功能及炎症因子的影响

目的探讨阿托伐他汀对老年高血压患者血管内皮功能的作用及抑制炎症因子的激活，以便更好地控制和治疗高血压疾病。方法将108例老年高血压患者自愿分为治疗组和对照组，各54例。对照组高血压患者进行常规的高血压治疗，治疗组患者在常规治疗基础上给予阿托伐他汀药物进行治疗。结果经过12周治疗后，常规治疗后对照组患者血脂各项指标较治疗前无太大改善，而治疗组血脂各项指标治疗后较治疗前有明显改善（P〈0．05）；治疗组C-反应蛋白（CRP）、血浆纤维蛋白原定量（FIB）、非创伤性血管内皮功能与治疗前有显著差异（P〈0．05），对照组治疗前后测定结果无明显差异（P〉0．05）。结论对于老年高血压患者，在常规进行降压治疗的同时，合并使用阿托伐他汀药物可以起到调节血脂的作用，能明显改善患者血管内皮功能及抑制炎症因子。     

Cumulative clinical trial data on atorvastatin for reducing cardiovascular events: the clinical impact of atorvastatin

ABSTRACT

Background: Since the 1990s a multitude of statin trials have definitively demonstrated the ability of statin therapy to reduce the risk of adverse coronary heart disease (CHD) events. Among these, the Atorvastatin Landmarks program – a group of 32 major atorvastatin trials – has assessed the efficacy and safety of atorvastatin across its full dose range and has helped illustrate its effectiveness in treatment of cardiovascular disease and its related disorders and also in non-cardiovascular outcomes.

Scope: This paper will review the major atorvastatin clinical trials and report the important findings and their clinical significance.

Findings: Clinical trials with atorvastatin have established significant reductions in cardiovascular events in patients with and without CHD. Studies show that high-dose atorvastatin will reduce LDL to ≈?70?mg/dL in many patients and improve cardiac outcomes. Current evidence suggests that high-dose atorvastatin can halt and, in some cases, reverse atherosclerotic progression. A study of diabetic patients showed atorvastatin decreased the occurrence of acute CHD events, coronary revascularizations, and stroke. Atorvastatin has been found to be effective for reducing nonfatal myocardial infarctions and fatal CHD in hypertensive patients with three or more additional risk factors. High-dose atorvastatin was found to be effective in reducing risk of recurrent stroke in patients with prior cerebrovascular events, has been shown to benefit patients suffering a recent acute coronary syndrome, and to slow cognitive decline in preliminary studies of patients with Alzheimer's disease. Atorvastatin has been associated with reduced progression of mild chronic kidney disease; however, in a randomized trial of patients with end stage renal disease on hemodialysis, atorvastatin showed no statistically significant benefit. Limitations of this review include lack of generalizablity of the atorvastatin trial data to other statins, lack of head to head outcome trials involving the newer more potent statins, and the relatively short study durations (none exceeded 5 years) when atherosclerosis is typically a decades-long disease.

Conclusion: A compelling body of evidence documents that atorvastatin reduces major cardiovascular events in both secondary and primary prevention of CHD and in a broad range of patients and disease conditions. Furthermore, throughout its dose range, atorvastatin is safe and well tolerated.     

阿托伐他汀钙联合羟乙基淀粉注射液治疗分水岭脑梗死的临床效果研究

目的分析阿托伐他汀钙联合羟乙基淀粉注射液对分水岭脑梗死患者急性期和远期临床治疗效果。方法选取本院2013年2月至2014年6月收治的分水岭脑梗死患者78例为研究对象,采用随机数表法将其分为观察组和对照组,每组各39例,两组患者均给予稳压、降糖、抗血小板聚集等常规治疗,对照组患者在此基础上加用阿托伐他汀钙,观察组患者给予阿托伐他汀钙联合羟乙基淀粉注射液,比较两组患者急性期和远期的临床效果。结果治疗后7天,观察组患者日常生活能力和神经功能恢复均明显优于对照组(P<0.05);治疗后3个月,观察组患者神经功能及日常生活能力恢复均明显优于对照组,且治疗总有效率明显高于对照组(χ2=7.47,P<0.01)。结论阿托伐他汀钙联合羟乙基淀粉注射液在分水岭脑梗死患者急性期和远期均有较好的临床治疗效果。     

阿托伐他汀治疗永久性房颤的效果分析

目的探讨阿托伐他汀对永久性房颤的疗效。方法将我院2009年1月-2010年1月间100例永久性房颤患者随机分为两组，在常规治疗基础上，观察组使用阿托伐他汀，对照组使用安慰剂，比较两组患者治疗前后心室率、治疗后凝血纤溶系统活性和血管内皮细胞功能之间的差异。结果经治疗，两组心室率均有显著下降，但组间未见显著差异。与对照组比较，观察组凝血系统活性降低，纤溶系统活性和血管内皮细胞功能增强。结论阿托伐他汀可有效降低永久性房颤患者体内高凝状态，提高纤溶系统活性，并保护血管内皮细胞。     

阿托伐他汀钙对老老年高血压合并高脂血症患者的降脂作用及安全性观察

目的 探讨阿托伐他汀钙在老老年高血压合并高脂血症患者中的降脂作用及安全性.方法 选择68例老老年患者,均服用阿托伐他汀钙20 mg(每晚1次),观察服药前后血脂、肝肾功能及肌酸激酶的变化情况.结果 与治疗前比较,治疗后患者的甘油三脂(TG)、总胆固醇(TCH)、低密度脂蛋白胆固醇(LDL-C)水平降低,高密度脂蛋白胆固醇(HDL-C)水平升高,患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肌酐(Cr)、尿素氮(BUN)、肌酸激酶(CK)无明显变化.结论 老老年高血压合并高脂血症患者应用阿托伐他汀钙降脂作用明显,且安全性较好.     

阿托伐他汀临床用药常见问题及合理用药分析

目的：分析阿托伐他汀临床常见问题，为合理用药提供科学依据。方法通过对我院2008年1月～2012年12月期间出现的29例阿托伐他汀不良反应的患者临床资料进行分析，总结阿托伐他汀临床用药常见问题，并提出合理用药措施。结果60岁以上老年患者出现阿托伐他汀不良反应者较高，所占比例为69.0%；患者不良反应发生时间均为药物服用后30min～3个月之内。联合用药患者中服用2～4种药物的患者有21例，所占比例为72.4%。临床不良反应以骨骼、肌肉损害最为常见，所占比例为48.3%。结论阿托伐他汀临床实际用药过程中应加强对患者血液、皮肤、肝、胆等方面的观察与监测，避免患者出现不良反应问题。     

Atorvastatin-loaded micelles with bone-targeted ligand for the treatment of osteoporosis

Osteoporosis is a common bone disorder where the declined bone mass is far more than normal physiological status and usually associated with enhanced fracture risk, reduced bone strength and even deteriorated quality of life. Recent studies showed that statins could exert beneficial effects on bones via promoting osteoblastic activity mediated by increased expression of bone morphogenetic protein 2 and also by suppressing osteoclast proliferation. In this study, we developed atorvastatin-loaded tetracycline-poly (ethylene glycol)-poly(lactic-co-glycolic acid) (TC-PEG-PLGA/ATO) micelles for the targeted treatment of osteoporosis. The TC-PEG-PLGA was synthesized under the action of coupling reagents and then ATO was encapsulated through solvent diffusion method with encapsulation efficiency and drug loading of 89.32?±?2.48% and 8.20?±?0.53%, respectively. The release of ATO from micelles could be maintained for more than 48?h in pH 7.4 PBS. Pharmacokinetic results further demonstrated that TC-PEG-PLGA micelles could effectively shield ATO leakage from micelles and prolong their circulation time. Benefiting from TC specifically binding to hydroxyapatite (HAp), TC-PEG-PLGA/ATO micelles exerted good bone-targeted ability, as demonstrated by in vitro HAp affinity assay and biodistribution. Pharmacodynamic studies showed that TC-PEG-PLGA/ATO micelles could effectively improve bone mineral density and bone mechanical strength in osteoporotic rats. These results suggest that TC-PEG-PLGA/ATO micelles hold significant promise for the targeted treatment of osteoporosis.