【阿托伐他汀】讲题5-强化他汀治疗

阿托伐他汀强化降脂治疗对冠心病心绞痛发作情况的影响分析发表时间：2018-08-31T15:10:17.150Z 来源：《医药前沿》2018年8月第23期作者：付玉鹏[导读] 对冠心病心绞痛患者应用阿托伐他汀强化降脂治疗能够显著缩短其心绞痛持续时间并可减少其发作次数。

（重庆市丰都县中医院重庆 408200）【摘要】目的：探析对冠心病心绞痛患者应用阿托伐他汀强化降脂治疗的效果。

方法：在我院就诊的冠心病心绞痛患者中随机抽取118例，将抽取对象分为对比组（n=57）和探析组（n=61），患者均应用冠心病心绞痛常规治疗，主要包括营养心肌、抗血小板、舒张冠脉血管等，若患者心绞痛发作则行硝酸甘油舌下含化治疗，对比组患者同时应用阿托伐他汀常规降脂治疗，探析组患者应用阿托伐他汀强化降脂治疗。

结果：对比组患者心绞痛持续时间明显长于探析组，两组数据对比差异有统计学意义（t=13.7356，P=0.0284），发作次数明显多于探析组，两组数据对比差异有统计学意义（t=10.3724，P=0.0459）。

治疗后对比组患者TC高于探析组，差异有统计学意义（t=12.8493，P=0.0298），TG高于探析组，差异有统计学意义（t=11.8737，P=0.0423），LDL-C高于探析组，差异有统计学意义（t=15.9272，P=0.0196）。

结论：对冠心病心绞痛患者应用阿托伐他汀强化降脂治疗能够显著缩短其心绞痛持续时间并可减少其发作次数。

【关键词】阿托伐他汀；强化降脂治疗；冠心病心绞痛【中图分类号】R541.4 【文献标识码】A 【文章编号】2095-1752（2018）23-0183-01 冠心病心绞痛属于心内科多发性慢性病，主要引发机制为心脏冠状动脉供血不足并导致心肌出现一过性缺血等表现，若患者病情不能及时得到有效抑制会进展为不稳定性心绞痛并加大其心肌梗死率，严重降低其生存质量[1]。

本研究旨在分析2015年10月2017年11月在我院接受冠心病心绞痛治疗的患者应用阿托伐他汀强化降脂治疗的效果，报告如下。

阿托伐他汀强化治疗脑梗死并颈动脉易损斑块临床疗效观察张逊娟;王贺【摘要】目的：观察阿托伐他汀强化治疗脑梗死并颈动脉易损斑块的临床效果。

方法选择2013年3月～2015年8月我院收治的脑梗死并颈动脉易损斑块患者96例，随机分为研究组和对照组，每组48例，在常规内科治疗的基础上，对照组加用每日10 mg阿托伐他汀治疗，研究组加用每日40 mg阿托伐他汀治疗。

治疗6个月后，比较两组治疗前后LDL-C和颈动脉易损斑块面积、内中膜厚度的变化。

结果治疗后，研究组LDL-C、颈动脉易损斑块面积以及IMT均优于治疗前，研究组治疗后上述指标优于对照组治疗后（P＜0.05）。

结论阿托伐他汀强化治疗脑梗死并颈动脉易损斑块可以改善患者的血脂水平，稳定颈动脉易损斑块。

%Objective To observe the clinical effect of atorvastatin in the treatment of cerebral infarction with vulnerable plaque of carotidartery.MethodsFrom 2013 March to August 2015, 96 cases with cerebral infarction and carotid plaque in patients in our hospital were randomly divided into study group and control group,48 cases in each group. On the basis of routine therapy,the control group was treated with 10 mg atorvastatin treatment,the study group and with every day 40 mg atorvastatin . After 6 months of treatment,the changes of LDL-C and carotid artery intima-media thickness and plaque area before and after treatment between the two groups were analyzed.Results After treatment,the study group LDL-C,vulnerable plaque area of carotid artery and IMT were significantly better than before treatment,the study group after treatment was also significantly better than the control group aftertreatment(P<0.05).Conclusion Atorvastatin intensive treatment of cerebral infarction and carotid vulnerable plaque can significantly improve the blood lipid levels of patients with stable carotid vulnerable plaque.【期刊名称】《中国卫生标准管理》【年(卷),期】2016(007)013【总页数】2页(P118-119)【关键词】阿托伐他汀;强化治疗;脑梗死;颈动脉易损斑块【作者】张逊娟;王贺【作者单位】吉林省人民医院神经内科，吉林长春 130021;吉林省人民医院神经内科，吉林长春 130021【正文语种】中文【中图分类】R743.3doi：10.3969/j.issn.1674-9316.2016.13.074【Abstract】Objective To observe the clinical effect of atorvastatin in the treatment of cerebral infarction with vulnerable plaque of carotid artery. Methods From 2013 March to August 2015， 96 cases with cerebral infarction and carotid plaque in patients in our hospital were randomly divided into study group and control group，48 cases in each group. On the basis of routine therapy，the control group was treated with 10 mg atorvastatin treatment，the study group and with every day 40 mg atorvastatin . After 6 months oftreatment，the changes of LDL-C and carotid artery intima-media thickness and plaque area before and after treatment between the two groups were analyzed. Results After treatment，the study group LDL-C，vulnerable plaque area of carotid artery and IMT were significantly better than before treatment，the study group after treatment was also significantly better than the control group after treatment（P＜0.05）. Conclusion Atorvastatin intensive treatment of cerebral infarction and carotid vulnerable plaque can significantly improve the blood lipid levels of patients with stable carotid vulnerable plaque.【Key words】Atorvastatin，Intensive treatment，Cerebral infarction，Carotid vulnerable plaque脑梗死是常见的神经系统疾病，动脉粥样硬化（AS）是发病的重要原因之一［1］。

阿托伐他汀第一篇：阿托伐他汀阿托伐他汀简介一．基本信息中文名称:阿托伐他汀中文别名:阿伐他汀;阿托伐他汀酸;(3S,5S)-7-[2-(4-氟苯基)-3-苯基-4-(苯基氨基甲酰基)-5-异丙基吡咯-1-基]-3,5-二羟基庚酸英文名称:Atorvastatin 英文别名:(3r,5rr)-7-[2-(4-fluorophenyl)-3-phenyl-4-(phenylcarbamoyl)-5-propan-2-yl-pyrrol-1-yl]-3,5-dihydroxy-heptanoic acid;[1]CAS:134523-00-5;110862-48-1 分子式:C33H33CaFNO5 分子量:582.6947 物化性质熔点 176-178°C 熔点:176-178℃药理毒理本品为HMG-CoA还原酶选择性抑制剂，通过抑制HMG-CoA还原酶和胆固醇在肝脏的生物合成而降低血浆胆固醇和脂蛋白水平，并能通过增加肝细胞表面低密度脂蛋白（LDL）受体数目而增加LDL的摄取和分解代谢。

本品也能减少LDL的生成和其颗粒数。

本品还能降低某些纯合子型家族性高胆固醇血症（FH）的低密度脂蛋白胆固醇（LDL-C）水平，而一类型的人群对其他类型的降脂药物治疗很少有应答。

本品能降低纯合子和杂合子家族性高胆固醇血症、非家族性高胆固醇血症以及混合性脂类代谢障碍患者的血浆总胆固醇（TC）、LDL-C和载脂蛋白B（ApoB），还能降低极低密度脂蛋白胆固醇（VLDL-C）和三酰甘油（TG）的水平，并能不同程度地提高血浆高密度脂蛋白胆固醇（HDL-C）和载脂蛋白A1（ApoA1）的水平。

1.9药代特征吸收：口服后迅速吸收，1-2小时内达到最大血浆浓度，吸收程度随口服剂量的增加而成正比例地增加。

绝对生物利用度约为12%，抑制HMG-CoA还原酶的全身利用度约为30%。

无论是否与食物同时服用或在一天中无论何时服用，其降低血浆LDL-C的效果都相似。

阿托伐他汀强化治疗可减少大脑中动脉支架置入后脑血管事件的发生高菊华;高小平;潘速跃【摘要】目的：观察已接受长期他汀治疗的脑梗死患者，大脑中动脉（middle cerebral artery, MCA）支架植入围手术期服用负荷剂量的阿托伐他汀对其近期脑血管事件的影响及机制探讨。

方法选择2010年1月~2014年11月在我科接受大脑中动脉支架植入术的脑梗死患者40例。

随机分为强化组（术前使用阿托伐他汀80 mg/d预处理3 d，术后原剂量巩固3 d，之后20 mg/d维持）和对照组（同期均匀给予阿托伐他汀20 mg/d），每组20例。

抽血检测术前24 h、术后24 h 血清high-sensitive C-reactive protein （hs-CRP）、soluable extracellular matrix metalloproteinase inducer（EMMPRIN/CD147）及 soluable vascular cell adhesion molecule-1（sVCAM-1）水平变化；术后1个月行神经专科及DSA随访，观察主要终点事件（支架内急性血栓形成、再狭窄、短暂性脑缺血发作、脑梗死复发、再次介入治疗及死亡）的发生情况。

结果两组术前24h各指标无差异（P>0.05）。

强化组术后24 h血清hs-CRP、sCD147及sVCAM-1水平显著低于对照组（P<0.05）；强化组血清hs-CRP、sCD147及sVCAM-1水平在支架植入术后较术前显著下降（P<0.05）。

对照组术后较术前有一定程度的升高（P>0.05）；术后1个月强化组主要终点事件发生率显著低于对照组（P<0.05）。

结论对于已接受长期他汀治疗的脑梗死患者，大脑中动脉支架植入围手术期服用负荷剂量的阿托伐他汀能显著降低血清hs-CRP、sCD147及sVCAM-1水平，减少脑血管事件的发生。

阿托伐他汀钙强化治疗对动脉粥样硬化脑梗死患者血脂水平及颈动脉斑块的影响吴霖浦【期刊名称】《广西医学》【年(卷),期】2016(38)1【摘要】目的：探讨阿托伐他汀钙强化治疗对动脉粥样硬化脑梗死患者血脂水平及颈动脉斑块的影响。

方法选择动脉粥样硬化脑梗死患者92例，以随机数字表法分为观察组和对照组各46例。

两组均给予饮食控制，对照组采用常规剂量阿托伐他汀钙（10 mg／d）治疗，观察组采用强化阿托伐他汀钙（40 mg／d）治疗，观察治疗前后两组患者血脂情况以及颈动脉斑块情况。

结果治疗后两组TC、TG、LDL-C水平、斑块大小、斑块厚度以及颈总动脉内膜－中层厚度（ IMT）均低于治疗前（P＜0．05），且观察组各项指标显著低于对照组（P＜0．05）；治疗后两组HDL-C水平升高（P＜0．05），且观察组较对照组明显增高（P＜0．05）。

结论强化剂量阿托伐他汀可有效改善动脉粥样硬化脑梗死患者血脂异常和颈动脉斑块的情况。

%Objective To explore the effect of intensive treatment with atorvastatin calcium on blood lipid level and carotid artery plaque in patients with atherosclerotic cerebral infarction .Methods A total of 92 patients with atherosclerotic cerebral infarction were enrolled and were divided into observation group ( n=46 ) and control group ( n=46 ) by random number table .The diet control was performed in both groups.And control group was administered atorvastatin calcium with normal dose (10 mg/d),while observation group received intensive treatment withatorvastatin calcium (40 mg/d).The blood lipid level and carotid artery plaque were observed in both groups before and after treatment.Results After treatment,the levels of TC,TG and LDL-C were significantly lower,and the plaque size, plaque thickness and carotid artery intima-media thickness(IMT) were less in both groups(P<0.05),and those indicators in the observation group improved more significantly compared to the indicators in the control group (P<0.05).The level of HLD-C increased in both groups after treatment(P<0.05),and the level in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Atorvastatin calcium with intensive dose can improve effectively the abnormity of blood lipid and carotid artery plaque in patients with atherosclerotic cerebral infarction .【总页数】3页(P71-73)【作者】吴霖浦【作者单位】广西桂林市人民医院神经内科，桂林市 541002【正文语种】中文【中图分类】R743.33【相关文献】1.阿托伐他汀钙片对脑梗死患者血脂水平及动脉粥样硬化的影响研究 [J], 杨文彬;庄建伟;林红2.阿托伐他汀钙对脑梗死病人颈动脉斑块及血流血脂水平的影响研究 [J], 黄泗霖;张萍;许伍环3.阿托伐他汀钙对老年急性脑梗死患者血脂水平及颈动脉粥样硬化的影响 [J], 叶红艳4.阿托伐他汀钙与匹伐他汀钙对急性脑梗死合并颈动脉粥样硬化斑块患者颈动脉斑块和血脂的影响 [J], 文洪波;黄健康;姚义琴;张凤5.阿托伐他汀与匹伐他汀对急性大动脉粥样硬化型脑梗死患者颈动脉斑块、血脂水平及安全性的影响 [J], 文洪波;杨军;邹荣成;姚义琴;徐岚;褚爱萍因版权原因，仅展示原文概要，查看原文内容请购买。