沥水调脂胶囊和舒降之片治疗高胆固醇血症的比较研究

目的　评价沥水调脂胶囊和舒降之片治疗高胆固醇血症的疗效与不良反应。方法　 6 6例高胆固醇血症的病人随机分成沥水调脂胶囊组 (A组 )和舒降之组 (B组 ) ;A组 33例给予沥水调脂胶囊 3粒 ,po,tid ,B组 33例给予舒降之 10mg ,po ,qd ;疗程均为 4周。结果　与治疗前相比 ,A组胆固醇 (TC)降低 ,有效率为 90 90 % ,甘油三脂 (TG)降低 ,有效率为 6 9 70 % ;B组TC降低 ,有效率为 93 33% ,TG降低 ,有效率为 5 1 5 1% ;A组和B组疗效间无显著性差异 (P >0 0 5 ) ,不良反应发生率两组间有显著性差异 (3 3%和 12 1% ,P <0 0 1)。结论　沥水调脂胶囊治疗高胆固醇血症与舒降之片相比 ,效果同样明显。     

血脂康对高脂血症患者血管内皮舒张功能的影响

目的比较高脂血症患者经血脂康治疗前后的血管内皮舒张功能的改变。方法应用高频血管探头检测56名高脂血症患者颈动脉内-中膜厚度(IMT)及在休息时、反应性出血、舌下含服硝酸甘油后的肱动脉内径,同时检测血浆胆固醇水平,肝功能及血清肌酸磷酸激酶(CK)等指标,服用血脂康10周后,复查上述指标,比较前后的变化。结果服血脂康10周后患者的血管内皮功能明显改善,血浆胆固醇水平明显降低,肝功能及血清肌酸激酶未见明显变化。结论血脂康在降低血脂的同时可逆转或延迟颈动脉IMT的进程,明显改善高脂血症患者的血管内皮功能,对患者的肝功能及血浆肌酸激酶无影响。     

Familial hypercholesterolemia supravalvular aortic stenosis and extensive atherosclerosis

Familial hypercholesterolemia is an autosomally dominant disorder caused by various mutations in low-density lipoprotein receptor genes. This can lead to premature coronary atherosclerosis and cardiac-related death. The symptoms are more severe in the homozygous type of the disease. Premature malignant atherogenesis leading to aortic root abnormalities causing supravalvular aortic stenosis is rare. Our case demonstrates the diagnostic imaging findings of the phenotype of patients who have severe elevated LDL with familial hypercolesterolemia.     

Effect of raloxifene on the incidence of elevated low density lipoprotein (LDL) and achievement of LDL target goals in postmenopausal women

SUMMARY

Objective: To determine the extent to which raloxifene can maintain low density lipoprotein cholesterol (LDL-C) levels below 160?mg/dL or reduce elevated LDL-C levels to below lipidlowering goals in postmenopausal women.

Patients and methods: The Multiple Outcomes of Raloxifene Evaluation (MORE) osteoporosis treatment trial randomized 7705 postmenopausal women to placebo or raloxifene (60?mg or 120 mg) daily for a core treatment phase of 3 years. Changes in LDL-C and other serum lipids in a subset of women was a predefined secondary objective. This post-hoc analysis included the 2413 women who did not take lipid-lowering medications at any time during the trial and for whom LDL-C measurements were available. The threshold for high LDL-C (≥ 160?mg/dL) and LDL-C lipid-lowering goals were defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guidelines.

Results: The percent of women with LDL-C < 160?mg/dL was comparable between treatment groups at baseline (placebo, 57.5%; raloxifene 60?mg, 56.4%; raloxifene 120?mg, 56.8%). At 3 years, the percent of these women whose LDL-C had increased to above 160?mg/dL was significantly less in the raloxifene 60?mg and 120?mg groups compared with placebo by 65% (95% CI, 44%–78%) and 64% (95% CI, 43%–77%), respectively. Among women with elevated (defined for these analyses as ≥ 160?mg/dL) LDL-C at baseline, the proportion having elevated LDL-C at 3 years was significantly less in the raloxifene 60?mg and 120?mg groups compared with placebo by 32% (95% CI, 24%–40%) and 40% (95% CI, 32%–48%), respectively. Fifty percent and 13% of these women achieved LDL-C goals of <160?mg/dL and <130?mg/dL, respectively (P <0.001 vs. placebo for both) in the raloxifene 60?mg group, with similar results for the raloxifene 120?mg group.

Conclusions: In postmenopausal women with osteoporosis not taking concurrent lipid-lowering therapy, raloxifene significantly reduced the incidence of LDL-C ≥ 160?mg/dL and significantly increased the proportion achieving LDL-C goals for lipid-lowering compared with placebo. Whether these and other effects of raloxifene on cardiovascular risk markers will improve cardiovascular outcomes requires further study.     

Sex-specific endothelial dysfunction induced by high-cholesterol diet in rats: The role of protein tyrosine kinase and nitric oxide

Background and aimsAtherosclerosis is a chronic process playing a crucial role in the pathogenesis of cardiovascular disease. Sex-specific differences in the incidence of atherosclerosis indicate that estrogen has a protective effect on the cardiovascular disease. However, the role of sex on endothelium responses in animal models of high cholesterol (HC) diet-induced atherosclerosis has not been fully investigated. This study was aimed to investigate vascular responses in HC-fed rats.Methods and resultsMale and female Sprague rats (12-week-old) were treated with either a standard diet (n = 12 of each sex) or an HC enriched diet (n = 12 of each sex) containing 2% cholesterol for 24 weeks. HC treated animals (both sexes) showed increased levels of total cholesterol, LDL-cholesterol, triglyceride and blood pressure (BP) compared to control rats. While the BP of control rats (both sexes) was increased following aminoguanidine administration (AG, 100 mg/kg i.p.), it was not changed in HC animals (both sexes). The hypotensive effect of acetylcholine was significantly impaired in male HC-treated rats. In vitro experiments demonstrated that aortic rings from HC group (both sexes) had an increased contractile response to phenylephrine and a decreased vasodilatory response to acetylcholine. The vasorelaxant effect of acetylcholine in HC rats (only male) was improved by applying 10^?5 M genistein (tyrosine kinase inhibitor) or AG.ConclusionHC diet alters endothelium function through Nitric oxide (NO) and tyrosine kinase pathways in male rats.     

阿托伐他汀对非酒精性脂肪肝的治疗研究

目的 探讨阿托伐他汀治疗非酒精性脂肪肝(NAFLD)的疗效.方法 选择 90 例NAFLD患者均分两组.予治疗组患者阿托伐他汀10mg/d口服治疗6个月.对照组患者则予辛伐他汀20mg/d口服.所有患者均禁酒 ,改善饮食结构 ,进行中等量有氧运动,控制体重.结果 治疗后治疗组临床症状、肝功能均获改善 ,治疗组ALT 较前下降明显.B超和CT 示脂肪肝程度减轻 ,血糖、血脂、体重指数较前下降(P <0.05).其中总胆固醇下降程度治疗组优于对照组(P <0.05).治疗组未出现不良反应.结论 在饮食控制、加强运动等基本治疗基础上 ,阿托伐他汀治疗可有效改善N A FLD患者肝功能、血糖、血脂代谢 ,减轻脂肪肝程度,耐受好 ,不良反应少 ,选用阿托伐他汀治疗安全有效.