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依折麦布对高脂血症并肝损患者的疗效和安全性观察
http://www.100md.com 2011年7月25日 吕荣 李道鸿 朱敖 严炜
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     [摘要] 目的 观察依折麦布对危险评估为高危的高脂血症并肝损患者的疗效和安全性。方法 肝损的高胆固醇血症30例和混合型高脂血症35例予依折麦布治疗,观察治疗后血脂变化、肝毒性和肌毒性。结果 治疗后第4、8周的肝功能和CK均未升高。两组治疗8周后血LDL-C下降明显,混合型高脂血症组血TC和TG治疗8周后均有下降,差异具有统计学意义(P<0.05)。结论 他汀类药物的肝毒性和肌毒性等使高脂血症并肝损的患者无法或惧怕使用他汀药物。依折麦布几乎不经细胞色素P450酶代谢,依折麦布单药治疗8周也能使合并肝损的高危高脂血症患者的血LDL-C和TC进一步下降,有良好的安全性,有理由相信血脂下降能使高危患者最终获益。

    [关键词]依折麦布;肝损;高脂血症

    [中图分类号] R589.2 [文献标识码] B[文章编号] 1673-9701(2011)21-76-02

    Efficacy and Safety of Observation on Liver Damage in Patients with Hyperlipidemia Treated with Ezetimibe

    LV RongLI DaohongZHU AoYAN Wei

    Jiangsu Province Wujiang City First People’s Hospital, Wujiang Hospital Affiliated of Nantong University,Wujiang 215200,China

    [Abstract] Objective To observe of ezetimibe on the risk assessment for the risk of liver damage in patients with hyperlipidemia and the efficacy and safety. Methods Liver damage in 30 patients with hypercholesterolemia and mixed hyperlipidemia ezetimibe 35 patients treated for blood lipid changes and liver toxicity and muscle toxicity. Results After 4,8 weeks of treatment, liver function and CK were not increased. two groups after 8 weeks of treatment serum LDL-C significantly decreased,mixed hyperlipidemia group of blood TC and TG were decreased after 8 weeks treatment(P<0.05). Conclusion Statin drugs such as liver toxicity and muscle toxicity and liver damage that hyperlipidemia in patients unable or afraid to use statin drugs.Almost without a break by Mab enzyme cytochrome P450 metabolism,ezetimibe monotherapy for 8 weeks also enable the combined risk of liver damage in the blood of patients with hyperlipidemia TC and LDL-C further decline,with good security reason to believe that decreased blood lipid can ultimately benefit patients at high risk.

    [Key words] Ezetimibe;Liver damage;Hyperlipidemia

    血脂异常是最重要的心血管疾病危险因素之一,降脂治疗,特别是血低密度脂蛋白(LDL-C)达标已成为防治冠状动脉粥样硬化性心脏病的核心策略。临床上常用的调脂药他汀是通过抑制肝脏的HMG-CoA还原酶来发挥活性作用,减少内源性胆固醇的合成,降低血液中的胆固醇(TC)水平。但他汀因其肝脏和肌肉等毒副作用,在高脂血症并肝损患者中使用受到限制或无法足量使用。依折麦布作为胆固醇吸收抑制剂是临床上使用的新型调脂药物,我们通过本研究来观察依折麦布在高脂血症并肝损患者中的调脂疗效和安全性。

    1资料与方法

    1.1一般资料

    选择2010年1月~2011年3月我院门诊和住院患者中依据《中国成人血脂异常防治指南》[1]评估为高危的高脂血症并肝损(血清AST或ALT>40U/L)患者65例 ......

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