某公司4201名体检人员血糖、血脂情况分析

目的分析某公司职工、家属的血糖和血脂的情况。方法将胜利油田某公司2012年1～11月在本院进行体检的职工、家属共4 201例受检人员作为研究对象,并按照10岁为一个年龄段分组,分析各个年龄组的高血脂和高血糖的检出情况。结果本次调查高血糖检出率为18.52%,高甘油三酯血症检出率为19.19%,高胆固醇血症检出率17%;且不同年龄组的高血糖及高胆固醇血症的患病率差异有统计学意义（P〈0.05）。结论某公司职工、家属的高血糖及血脂异常情况不容乐观,应加强其血糖和血脂的定期监测,积极开展健康教育,养成健康的生活方式。     

冠状动脉粥样硬化大鼠实验动物模型的改进与评价

目的：本研究通过对文献报道的动脉粥样硬化大鼠造模方法的改进,建立一种适合进行心血管疾病研究的冠状动脉粥样硬化Wistar大鼠模型。方法：将40只大鼠随机分为对照组与模型组,对照组15只,模型组25只。模型组高脂饲料喂养配合前3个月每月按15万u/kg每月腹腔注射维生素D3一次,对照组喂养普通饲料,造模时长150天。实验结束后通过对血管内皮、脂代谢、炎症浸润几个方面对模型大鼠进行考察。结果：证实模型组大鼠较对照组血清LDL-C、CHO、TG水平明显升高,HDL-C/LDL-C、NO/ET-1值明显降低;AI值显著增高;血清NO、ET-1、ox-LDL、AngⅡ、sICAM-1表达明显增高;HE染色显示：模型组大鼠冠状动脉出现血栓、内皮破坏、粥样斑块形成,血管壁钙化情况;心肌纤维组织增生,炎细胞浸润,心肌轻度变性;主动脉出现动脉粥样硬化斑块形成,而对照组无病变产生。结论：通过改进后,本方法能够提供一种稳定的、复制性好的用于冠状动脉粥样硬化实验研究的大鼠模型。     

Colesevelam in the treatment of hypercholesterolemia and hyperglycemia: a retrospective analysis from an ambulatory care medical network

Abstract

Objective:

To examine outcomes associated with colesevelam treatment among patients with hypercholesterolemia in real-world clinical practice.     

Long-term safety and tolerability of ezetimibe coadministered with simvastatin in hypercholesterolemic patients: a randomized, 12-month double-blind extension study

ABSTRACT

Objectives: To assess the long-term safety and tolerability and to further evaluate the effect of ezetimibe plus simvastatin on LDL-C, HDL-C, and triglyceride levels in subjects with primary hypercholesterolemia.

Methods: This was a 12-month, double-blind, placebo-controlled extension study that enrolled patients with primary hypercholesterolemia who had successfully completed the 12-week, double-blind, placebo-controlled trial of ezetimibe coadministered with simvastatin. The initial dose administered to patients in the extension was ezetimibe 10 mg coadministered with simvastatin 10 mg with the option to up-titrate statin dosage if LDL-C goals were not met. Safety and tolerability were assessed through clinical and laboratory adverse experiences (AEs). Changes from baseline in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were measured.

Results: Overall, 87 patients were randomized to receive ezetimibe + simvastatin and 22 were randomized to receive simvastatin and placebo. Treatment-emergent AEs were reported for 72/87 (83%) ezetimibe + simvastatin-treated patients and for 17/22 (77%) simvastatin-treated patients. The most commonly reported AEs in the simvastatin treatment group were hypertension, gastro-esophageal reflux, and musculoskeletal pain (each reported by 3/22 [14%] patients); and in the ezetimibe + simvastatin group were upper respiratory tract infection (16/87 [18%]), arthralgia and musculoskeletal pain (both reported by 10/87 [11%] patients). Drug-related AEs were reported for 3/22 (14%) simvastatin-treated patients and 21/87 (24%) patients in the coadministration group. AEs considered serious by the investigator were reported by 2/22 (9%) patients taking simvastatin monotherapy and by 20/87 (23%) patients taking ezetimibe + simvastatin. Discontinuations due to AEs occurred in no patients taking simvastatin monotherapy and in 7/87 (8%) patients taking ezetimibe + simvastatin. Percent change ± standard deviation from baseline in LDL-C was ?29% ± 15.4 and ?44% ± 14.2 in subjects taking simvastatin monotherapy and ezetimibe + simvastatin, respectively.

Conclusions: Ezetimibe coadministered with simvastatin was generally well-tolerated and no new safety concerns were raised. Both treatments effectively maintained improvements in lipid parameters throughout the course of the studies. Interpretation of these results was limited by the small convenience sample included in the trial.     

Systematic, immediate in-hospital initiation of lipid-lowering drugs during acute coronary events improves lipid control

Background: Patients who have had a coronary heart attack often go completely untreated for hypercholesterolemia. We investigated whether immediate initiation of lipid-lowering drugs during hospitalization for acute coronary events increases the proportion of correctly treated patients compared to referred treatment as recommended by current guidelines. Methods: This prospective, multicenter study randomized 57 hypercholesterolemic patients hospitalized for acute coronary events to immediate in-hospital initiation or to referred initiation of lipid-lowering drugs by primary care physicians 3 months after unsuccessful nutritional intervention. Results: After 6 months, 53 patients were available for follow-up. More patients in the immediate initiation group (26/30 patients, 87%) were treated with lipid-lowering drugs than in the referred initiation-group (13/23 patients, 57%, P=0.03). Twenty-seven patients (87%) in the immediate initiation group versus 17 patients (65%) in the referred initiation group had a 10% or greater decrease in total cholesterol or a 15% or greater decrease in LDL-cholesterol (P=0.18). Although statistically not significant, there was a trend to improved lipid values in the immediate initiation group compared to the referred initiation group (TC, −21.1 vs. −13.8% (P=0.08); LDL-C, −28.2 vs. −18.9% (P=0.13); HDL-C, +10.8 vs. +5% (P=0.44); TC/HDL-C ratio, −24.7 vs. −15.1% (P=0.22)), and the LDL-C/HDL-C ratio was −34.1 vs. −19.1% (P=0.04, P=NS after Bonferroni correction). Conclusion: The immediate initiation of lipid-lowering drugs in hypercholesterolemic patients hospitalized for acute coronary events increases the rate of correctly treated patients and has the potential to improve lipid control.     

瑞舒伐他汀钙治疗高胆固醇血症的有效性与安全性研究

目的探讨瑞舒伐他汀钙治疗高胆固醇血症的有效性和安全性,为临床安全用药提供参考。方法选择海南医学院附属医院2011年12月至2012年12月高胆同醇血症患者,经4周筛选出符合入选条件的患者129例,按随机数字表法分为3组。A组43例患者给予瑞舒伐他汀钙5mg治疗,B组43例患者给予10mg瑞舒伐他汀钙治疗,对照组43例患者给予10mg阿托伐他汀钙治疗,12周后对3组患者血脂指标进行观察,同时记录3组患者的不良反应。结果A组、B组、对照组治疗12周后LDL—C分别较治疗前降低2．2、2．3、1．8mmol／L;TC分别较治疗前降低2．2、2．3、1．8mmol／L;A组与B组下降幅度均大于对照组,组问比较差异有统计学意义（P〈0．05）。3组HDL—C较治疗前有明显升高,TG较治疗前明显降低,但组间比较差异无统计学意义（P〉0．05）。A组与B组无明显不良反应,对照组出现不良反应2例,其中1例为AST、ALT水平升高,不良反应发生率为4．6％。组间比较差异有统计学意义（P〈0．05）。结论瑞舒伐他汀钙能有效降低高胆固醇血症患者LDL—C、TC,具有显著的疗效与较高的安全性。     

瑞舒伐他汀和辛伐他汀治疗老年冠心病伴高胆固醇血症的疗效比较

目的对比研究瑞舒伐他汀和辛伐他汀治疗老年冠心病伴高胆固醇血症的疗效。方法选取2009年3月-2012年6月人院进行治疗的冠心病伴高胆固醇血症患者118例,随机分为对照组和研究组,对照组患者采用辛伐他汀进行治疗,研究组患者采用瑞舒伐他汀进行治疗,治疗前后观察记录两组患者血脂变化,记录患者不良反应及并发症发生情况。结果治疗后,研究组患者TC及LDL-C水平较对照组下降明显,差异具有统计学意义（P〈0．05）,但是在TG及HDL-C水平两项上差异无统计学意义（P〉0．05）。两组均未H;现影响病情的严重不良反应,肝肾功能正常．不良反应主要以恶心呕吐、食欲下降以及轻微的上呼吸道感染为主。结论小剂量瑞舒伐他汀较辛伐他汀在降低TC、LDL-C水平方面疗效显著,安全性高,研究前景广阔。     

Health-promotion interventions enhance and maintain self-efficacy for adults at cardiometabolic risk: A randomized controlled trial

ObjectivesTo investigate whether a community-based intervention program, based on self-efficacy theory, might improve older adults’ self-care behaviors as well as health outcomes related to hypertension and dyslipidemia.MethodsThis randomized controlled trial was conducted in Taipei, Taiwan, From October 16, 2011 to July 31, 2014. Residents identified during community screening for the over 50 s were invited to participate if their blood pressure was 120–139/80–89 mmHg, high-density lipoprotein cholesterol was <40 mg/dL (men) or <50 mg/dL (women), or low-density lipoprotein cholesterol was 130–159 mg/dL. The intervention group participated in a special health promotion program; the control group received conventional health education. Participants’ demographic and anthropometric data were recorded, and each completed semi-structured questionnaires about hypertension and cholesterol management, and gave blood samples for biochemical analyses before the intervention and 6 months after it ended.ResultsFrom 90/98 eligible subjects who enrolled, 84 completed the study: 41/43 and 43/47 respectively in intervention and control groups. Body mass index, blood pressure, hyperglycemia, and high-density lipoprotein cholesterol in the intervention group improved significantly from baseline. The Self-Efficacy Scale (P = 0.020), Self-Care Activities Questionnaire (P = 0.014) and Perceived Therapeutic Efficacy Scale (P = 0.023) scores improved significantly.ConclusionThis health promotion intervention program enhanced self-efficacy among older adults, with sustained effect through 6-months’ follow-up. These findings are consistent with studies that evaluated the effect of a diabetes education program on self-efficacy. The beneficial effect on a population at high-risk for hypertension and hypercholesterolemia, may serve as a model for developing and implementing such interventions.     

Analbuminémie congénitale compliquée d’un syndrome coronarien aigu récidivant : à propos d’un cas et revue de la littérature

Congenital analbuminemia (CAA) is a very rare disorder with an estimated prevalence of less than one in one million. This anomaly can be lethal at birth and in early infancy but it's not very symptomatic in adulthood. The clinical signs are edema, lipodystrophy, fatigue… Hypercholesterolemia is the main biological disorder and it predisposes to cardiovascular complications. The mild symptoms of CAA leads to delay diagnosis. That's why clinical and biological signs of this disorder should be known by both of biologist and clinician to establish an early diagnosis in order to prevent cardiovascular complications. We report a new case of congenital analbuminemia complicated by recurrent acute coronary artery disease in 34-year-old man. This complication has been reported only once according to the register of analbuminemia cases.     

Endothelial cell heterogeneity in experimentally-induced rabbit atherosclerosis. Demonstration of multinucleated giant endothelial cells by scanning electron microscopy and cell culture

We investigated the aortic endothelial cells of cholesterol-fed rabbits, using scanning electron microscopy and a cell culture technique. Rabbits were given a 1% cholesterol diet intermittently for up to 40 weeks. In these animals, the area of endothelial cells was increased and the cells showed polymorphism in relation to the progression of atherosclerosis. In animals fed the cholesterol diet for 12, 28 and 40 weeks, the average area of the endothelial cells was 436±15, 762±153, and 836±165 m², respectively. In the cholesterol-fed 40-week group, in particular, giant endothelial cells, measuring more than 1200 m², accounted for 14% of the population. In animals fed a standard diet there was no significant difference in endothelial cell morphology between control 0-week and control 40-week groups; in both, the luminal surface of the thoracic aorta formed a homogeneous sheet covered by small rhomboidal endothelial cells, the area of most being less than 400 m². Primary cultured endothelial cells harvested from those control groups were mononuclear typical small cells with a centrally located nucleus; the proportion of binucleated cells was less than 2% and no multinucleated giant cells with three or more nuclei were detected. Endothelial cells from the cholesterol-fed groups, however, contained larger numbers of binucleated cells, with the number increasing in proportion to the duration of cholesterol feeding. The major distinguishing feature of the endothelial cells in the cholesterol-fed groups was the presence of multinucleated giant cells with three or more nuclei; these accounted for 2.3% and 3.3% of the total cell population in the cholesterol-fed 28- and 40-week groups, respectively. No bromodeoxyuridine uptake was found in the nuclei of the cultured multinucleated giant cells. Heterogeneity of endothelial cells, with the concomitant appearance of multinucleated giant cells, emerges with the progression of diet-induced atherosclerosis. The morphological alterations of endothelial cells observed in the present study intimately reflect changes in their function associated with the progression of atherosclerotic lesions.