他汀类药物的研究进展与临床应用评价Research Progress on Statins and Evaluation on Its Clinical Application
杜海燕;林阳;
摘要(Abstract):
目的:评价他汀类药物的研究进展,以供临床医师合理用药参考。方法:查阅近年来国内外的相关文献资料,进行归纳和分析。结果与结论:他汀类药物不仅能降低血清胆固醇水平,还通过改善血管内皮功能、抗炎及抗氧化作用、抗血小板聚集和抑制血栓形成、稳定粥样硬化斑块、抑制平滑肌细胞增殖及迁移等其他多效性,在冠状动脉粥样硬化性心脏病、缺血性脑卒中、糖尿病血管病、心律失常、阿尔茨海默病、高血压等心血管疾病中发挥其作用。国内冠心病患者目前他汀类药物的使用状况存在明显不足,说明这方面的循证医学证据还亟待转化为科学规范的临床实践。
关键词(KeyWords): 他汀类药物;研究进展;临床应用;不良反应
基金项目(Foundation):
作者(Authors): 杜海燕;林阳;
DOI: 10.14009/j.issn.1672-2124.2011.06.019
参考文献(References):
- [1]金有豫.药理学[M].北京:人民卫生出版社,2001:201-206.
- [2]Singh U,Devaraj S,Jialal I,et al.Comparison effect ofatorvastatin(10 versus 80 mg)on biomarkers of inflammationand oxidative stress in subjects with metabolic syndrome[J].Am J Cardiol,2008,102(3):321.
- [3]Kagami S,Kanari H,,Suto A,et al.HMG-CoA reductase inhibitor simvastatin inhibits pro-inflammatory cytokineproduction from murine mast cells[J].Int Arch AllergyImmunol,2008,146(suppl 1):61.
- [4]Montecucco F,Burger F,Pelli G,et al.Statins inhibit C-reactive protein-induced chemokine secretion,ICAM-1upregulation and chemotaxis in adherent human monocytes[J].Rheumatology(Oxford),2009,46(5):612.
- [5]Ridker PM,Cannon CP,Morrow D,et al.C-reactiveprotein levels and outcomes after statin therapy[J].NEngl J Med,2005,352(1):20.
- [6]Deedwania P,Stone PH,Bairey Merz CN,et al.Effects of ntensive versus moderate lipid lowering therapy onmyocardial ischemia in older patients with coronary heartdisease:Results of the study assessing goals in the elderly(SAGE)[J].Circulation,2007,115(6):700.
- [7]Wenger NK,Lewis SJ,Herrington DM,et al.Treating to new targets study steering committee and investigators.Outcomes of using high or low dose atorvastatin in patients65 years of age or older with stable coronary heart disease[J].Ann Intern Med,2007,147(1):1.
- [8]Olsson AG,Schwartz GG,Szarek M,et al.Effects of high dose atorvastatin in patients>or=65 years of age withacute coronary syndrome from the myocardial ischemiareduction with aggressive cholesterol lowering[MIRACL]study[J].Am J Cardiol,2007,99(5):632.
- [9]Ozova EM,Kiiakbaev GK,Kobalava ZhD.Inflammationand chronic heart failure role of statins[J].Kardiologiia,2007,47(1):52.
- [10]Heeba G,Hassan MK,Khalifa M,et al.Adverse balance of nitric oxide/peroxynitrite in the dysfunctional endotheliumcan be reversed by statins[J].J Cardiovasc Pharmacol,2007,50(4):391.
- [11]Jantzen F,Knemann S,Wolff B,et al.Isoprenoid depletion by statins antagonizes cytokine-induced down-regulation ofendothelial nitric oxide expression and increases NOsynthase activity in human umbilical vein endothelial cells[J].J Physiol Pharmacol,2007,58(3):503.
- [12]Wenzel P,Daiber A,Oelze M,et al.Mechanismsunderlying recoupling of eNOS By HMG-CoA reductaseinhibition in a rat model of streptozotocin-induceddiabetesmellitus[J].Atherosclerosis,2008,198(1):65.
- [13]Besler C,Doerries C,Giannotti G,et al.Phamacological approaches to improve endothelial repair mechanisms[J].Expert Rev Cardiovasc Ther,2008,6(8):1071.
- [14]Vincent L,Chen W,HongL,et al.Inhibition of endothelial cell migration by cerivastatin,an HMG-CoA reductaseinhibitor:contribution to its anti-angiogenic effect[J].FEBS Lett,2001,495(3):159.
- [15]Negre AP,Van EM,Van LRE,et al.Differential effect of simvastatin on various signal transduction intermediates incultured human smooth muscle cells[J].BiochemPharmacol,2001,61(8):991.
- [16]Sawada N,Itoh H,Nakao K.Novel actions of HMG-CoA reductase inhibitors(statins)——vascular and cerebralprotection through inhibition of small GTPase Rho[J].Nippon Rinsho,2001,59(12):2470.
- [17]Yamakawa T,Tanaka S,Kamei J,et al.Pitavsatatin inhibits vascular Smooth muscle cell proliferation byinactivating extracellular signal-regulated kinase 1/2[J].J Atheroscler Thromb,2003,10(1):37.
- [18]曲莉,刘宗武,赵学忠.他汀类药物多效性研究进展[J].中国老年学杂志,2010,30(2):280.
- [19]Rodríguez-Vita J,Sánchez-Galán E,Santamaría B,et al.Essential role of TGF-beta/Smad pathway on statindependentvascular smoothmuscle cell regulation[J].PLoSOne,2008,3(12):e3959.
- [20]Laufs U,Gertz K,Huang P,et al.Atorvastatin upregulatestype Ⅲ itric oxide synthase in thrombocytes,decreasesplatelet activation,and protects from cerebral ischemia innormocholesterolemicmice[J].Stroke,2000,31(10):2442.
- [21]Gertz K,Laufs U,Lindauer U,et al.Withdrawal of stat intreatment abrogates stroke protection in mice[J].Stroke,2003,34(2):551.
- [22]Undas A,Brummel-Ziedins KE,Potaczek DP,et al.Atorvastatin and quinapril inhibit blood coagulation inpatients with coronary artery disease following 28 days oftherapy[J].J Thromb Haemost,2006,4(11):2397.
- [23]Lacut K,Oger E,Legal G,et al.Statins but not fibrates areassociated with a reduce drisk of venous thromboembolism:ahospital-based case-control study[J].Fundam ClinPharmacol,2004,18(4):477.
- [24]The Long term Intervention with Pravastatin in lschemicDisease(LIPID)Study Group.Prevention of cardiovasculsrevents and death with pravastatin in patients with coronaryhead disease and abroad range of initial cholesterol levels[J].N Engl J Med,1998,339(19):1349.
- [25]胡大一,马长生.心脏病学实践[M].北京:人民卫生出版社,2007:361-369.
- [26]Pasceri V.Atorvastatin for reduction of myocardial damageduring angioplasty[J].Circulation,2004,110(6):674.
- [27]Patti G,Pasceri V,Colonna G,et al.Atorvastatin pretreatmentimproves outcomes in patients with acute coronary syndromesundergoing early percutaneous coronary intervention:resultsof the ARMYDA-ACS randomized trial[J].J Am CollCardiol,2007,49(12):1272.
- [28]Briguori C,Visconti G,Focaccio A,et al.Novelapproaches for preventing or limiting events(Naples)ⅡTrial impact of a single high loading dose of atorvastatinon periprocedural myocardial infarction[J].J Am CollCardiol,2009,54(23):2157.
- [29]DiSciascio G,Patti G,Pasceri V,et al.Efficacy ofatorvastatin reload in patients on chronic statin therapyundergoing percutaneous coronary intervention:results ofthe ARMYDA-RECAP-TURE(Atorvastatin for Reductionof Myocardial Damage During Angio plasty)RandomizedTrial[J].J Am Coll Cardiol,2009,54(6):558.
- [30]方向华.卒中的流行趋势、危险因素研究与预防模式[J].脑血管病理论与实践,2006:23.
- [31]郭佳,田金徽,杨克虎,等.他汀类药物预防卒中再发的系统评价[J].中国循证医学杂志,2009,9(5):565.
- [32]杨燃,杨红敏,付志新,等.辛伐他汀对血脂异常人群缺血性脑卒中的预防[J].中华老年心脑血管病杂志,2006,8(12):833.
- [33]Ovbiagele B,Saver JL.Intensive stain therapy after stmkeor transient ischemic attack:a SPARCLing success[J]?Stroke,2007,38(3):1110.
- [34]王兴全.解读他汀类药物防治IS/TIA的专家共识[J].中国实用医药,2010,5(12):250.
- [35]Matafome P,Nunes E,Louro T,et al.A role for atorvastatinand insulin combination in protecting from liver injury in amodel of type 2 diabetes with hyperlipidemia[J].NaunynSchmiedebergs Arch Pharmacol,2009,379(3):241.
- [36]Villalba JM,Parrado C,Santos-Gonzalez M,et al.Therapeutic use of coenzyme Q(10)and coenzyme Q(10)-related compounds and formulations[J].ExpertOpin Investig Drugs,2010,19(4):535.
- [37]Rajpathak SN,Kumbhani DJ,Crandall J,et al.Statintherapy and risk of developing type 2 diabetes:a meta-analysis[J].Diabetes Care,2009,32(10):1924.
- [38]Matikainen N,Kahri J,Taskinen MR.Reviewing statintherapy in diabetes-towards the best practice[J].PrimCare Diabetes,2010,4(1):9.
- [39]Imai E,Hamano T.Clinical study on nephrology[J].Nippon Jinzo Gakkai Shi,2010,52(1):13.
- [40]Chapman MJ,Redfern JS,McGovern ME,et al.Niacin andfibrates in atherogenic dyslipidemia:pharmacotherapy toreduce cardiovascular risk[J].Pharmacol Ther,2010,126(3):314.
- [41]Kostapanos MS,Milionis HJ,Elisaf MS.Rosuvastatin-associated adverse effects and drug-drug interactions inthe clinical setting of dyslipidemia[J].Am J CardiovascDrugs,2010,10(1):11.
- [42]Nicholls SJ,Brandrup-Wognsen G,Palmer M,et al.Meta-analysis of comparative efficacy of increasing dose ofAtorvastatin versus Rosuvastatin versus Simvastatin onlowering levels of atherogenic lipids(from VOYAGER)[J].Am J Cardiol,2010,105(1):69.
- [43]Wierzbicki AS,Viljoen A.Hyperlipidaemia in paediatricpatients:the role of lipid-lowering therapy in clinicalpractice[J].Drug Saf,2010,33(2):115.
- [44]陈莉,陈灿,黄石安,等.他汀类药物与心房颤动[J].中国实用医药,2010,5(23):257.
- [45]Haag MD,Hofman A,Koudstaal PJ,et al.Statins areassociated with a reduced risk of Alzheimer diseaseregardless of lipophilicity.The Rotterdam Study[J].JNeurol Neurosurg Psychiatry,2009,80(1):13.
- [46]Galus R,Jozwiak JW,lodarski K,et al.Polskimerkuriuszlekarsk:i organ polskie go to warzystwa lekarskiego[J].Inter Sci J,2008,24(144):545.
- [47]Sparks DL,Sabbagh MN,Connor DJ,et al.Atorvastatinfor the treatment of mild to moderate Alzheimer disease:preliminary results[J].Arch Neurol,2005,62(5):753.
- [48]付婕琴,刘海洋,胡昌华.他汀类药物治疗阿尔茨海默病的非降脂作用新机制[J].中国药学杂志,2010,45(11):804.
- [49]Derosa G,Maffioli P.Effects of amlodipine plus atorvastatinassociation in hypertensive hypercholesterolemic patients[J].Expert Rev Cardiovasc Ther,2010,8(6):835.
- [50]Amin KA,Abd El-T wab TM.Oxidative markers,nitricoxide and homocysteine alteration in hypercholesterolimicrats:role of atorvastatine and cinnamon[J].Int J ClinExp Med,2009,2(3):254.
- [51]胡大一,王振纲.防治冠心病和高血压的药物他汀类[J].中国全科医学杂志,2000,3(2):141.
- [52]Azar RR,Badaoui G,Sarkis A,et al.Effect of ezetimibe/atorvastatin combination on oxidized low densitylipoprotein cholesterol in patients with coronary arterydisease or coronary artery disease equivalent[J].Am JCardiol,2010,106(2):193.
- [53]Moride Y,Hegele RA,Langer A,et al.Clinical and publichealth assessment of benefits and risks of statins inprimary prevention of coronary events:resolved andunresolved issues[J].Can J Cardiol,2008,24(4):293.
- [54]Caso G,Kelly P,McNurlan MA,et al.Effect of coenzymeq10 on myopathic symptoms in patients treated withstatins[J].Am J Cardiol,2007,99(10):1409.
- [55]Backes JM,Howard PA.Association of HMG-CoA reductaseinhibitors with neuropathy[J].Ann Pharmacother,2003,37(3):274.
- [56]Baker SK,Tarnopolsky MA.Statin-associated neuromyo-toxicitv[J].Drugs Today(Barc),2005,41(4):267.
- [57]Focking M,Besselman NM,Trapp T.Statins potentiatecaspase-3 activity in immortalized murine neurons[J].Neurosci Lett,2004,355(1-2):41.
- [58]李静,蒋立新,李希,等.他汀类药物在中国冠心病患者中的应用现状调查[J].中国循环杂志,2010,25(5):348.
- [59]Kotseva K,Wood D,De Backer G,et al.EUROASPIREⅢ:a survey on the lifestyle,risk factors and use ofcardioprotective drug therapies in coronary patients from22 European countries[J].Eur J Cardiovasc PrevRehabil,2009,16(2):121.