The present study investigated the association between pre-treatment with a cholesterol-lowering drug(statin) or new setting hereon and the effect on the mortality rate in patients with acute ischemic stroke who recei...The present study investigated the association between pre-treatment with a cholesterol-lowering drug(statin) or new setting hereon and the effect on the mortality rate in patients with acute ischemic stroke who received intravenous systemic thrombolysis. During a 5-year period(starting in October 2008), 542 consecutive stroke patients who received intravenous systemic thrombolysis with recombinant tissue plasminogen activator(rt-PA) at the Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany, were included. Patients were characterized according to statins. The primary endpoint was mortality;it was assessed twice: in hospital and 3 months after discharge. The secondary outcome was the rate of symptomatic intracerebral hemorrhage. Of the 542 stroke patients examined(mean age 72 ± 13 years;51% women, mean National Institutes of Health Stroke Scale(NIHSS) score 11), 138 patients(25.5%) had been pretreated with statin, while in 190 patients(35.1%) statin therapy was initiated during their stay in hospital, whereas 193(35.6%) never received statins. Patients pre-treated with statin were older and more frequently had previous illnesses(arterial hypertension, diabetes mellitus and previous cerebral infarctions), but were comparably similarly affected by the stroke(NIHSS 11 vs. 11;P = 0.76) compared to patients who were not on statin treatment at the time of cerebral infarction. Patients pretreated with statin did not differ in 3-month mortality from those newly treated to a statin(7.6% vs. 8%;P = 0.9). Interestingly, the group of patients pretreated with statin showed a lower rate of in hospital mortality(6.6% vs. 17.0;P = 0.005) and 3-month mortality(10.7% vs. 23.7%;P = 0.005) than the group of patients who had no statin treatment at all. The same effect was seen for patients newly adjusted to a statin during the hospital stay compared to patients who did not receive statins(3-month mortality: 7.1% vs. 23.7%;P < 0.001). With a good functional outcome(mRS ≤ 2), 60% of patients were展开更多
目的观察与探究他汀类药物在短暂性脑缺血发作预防中的效果及对脑血流参数的影响情况。方法选取2016年6月至2017年5月杭州师范大学附属医院收治的80例在短暂性脑缺血发作患者为研究对象,将所有患者按照治疗方式的不同分为对照组和观察组...目的观察与探究他汀类药物在短暂性脑缺血发作预防中的效果及对脑血流参数的影响情况。方法选取2016年6月至2017年5月杭州师范大学附属医院收治的80例在短暂性脑缺血发作患者为研究对象,将所有患者按照治疗方式的不同分为对照组和观察组,每组40例。对照组进行常规治疗干预,观察组则在对照组的基础上加用他汀类药物;比较两组患者不同时间短暂性脑缺血发作的发生率、脑梗死发生率及治疗前后的脂代谢指标、脑血流参数、不良反应发生率。结果治疗后不同时间段观察组的短暂性脑缺血发作发生率及脑梗死发生率均低于对照组(χ~2=4.211、6.275、5.698、4.211、5.333、6.135,P均<0.05),治疗前两组的脂代谢指标及脑血流参数(血流速、血流量及相关阻力指标)比较,差异无统计学意义(P>0.05),治疗后观察组的血流速及血流量、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)均高于对照组,相关阻力指标及其他脂代谢指标均低于对照组(P均<0.05),两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论他汀类药物在短暂性脑缺血发作预防中的效果较好,且对患者的脑血流参数具有积极的改善作用,因此在短暂性脑缺血发作患者治疗中有一定的应用价值。展开更多
Nephrotic syndrome is a relatively common clinical disease.Associated dyslipidemia is a risk factor for the occurrence and development of cardiovascular and renal diseases that might gradually develop into atheroscler...Nephrotic syndrome is a relatively common clinical disease.Associated dyslipidemia is a risk factor for the occurrence and development of cardiovascular and renal diseases that might gradually develop into atherosclerosis,glomerulosclerosis or tubulointerstitial injury.It also confers an elevated risk of complications such as thromboembolism.If not properly controlled over the long term,dyslipidemia will become a key factor in a poor prognosis.Furthermore,dyslipidemia correlates with an increase in hepatic compensatory synthetic lipoprotein levels and a decrease in lipoprotein clearance,which can be sourced to the downregulation of hepatic and lipoprotein lipase activities in endothelial cells,muscle,and adipose tissue,and clinically characterized as hypertriglyceridemia or hypercholesterolemia.However,further investigations into the mechanism(s)of dyslipidemia are needed,with the resultant detailed perspectives and analyses substantially aiding the further development of treatment guidelines.Currently,statins represent the most popular type of pharmaceutical intervention because they lower hepatic cholesterol production and promote the absorption of low-density lipoprotein-cholesterol from the bloodstream,followed by second-line and other potential therapies to regulate the expression of specific receptors.展开更多
冠心病严重威胁中老年人的健康。经皮冠状动脉介入治疗是治疗冠心病的方法之一,其创伤小、痛苦少、血管开通率高、出血并发症低等优点,被临床广泛采用。但在手术中对粥样斑块的挤压、血管内膜的撕裂、血小板激活以及促进炎症介质释放等...冠心病严重威胁中老年人的健康。经皮冠状动脉介入治疗是治疗冠心病的方法之一,其创伤小、痛苦少、血管开通率高、出血并发症低等优点,被临床广泛采用。但在手术中对粥样斑块的挤压、血管内膜的撕裂、血小板激活以及促进炎症介质释放等因素引起心肌缺血再灌注损伤进而影响预后。他汀类药物除治疗动脉粥样硬化,还有抗炎、抗氧化、改善内皮功能、改善心肌重构、减少神经内分泌的激活等作用。应用他汀类药物在P C I手术进行缺血后适应发挥保护心肌的作用,对改善患者的预后有着重要的意义。本文对PCI术前应用他汀类药物进行缺血后适应减轻心肌损伤的机制作一综述。展开更多
文摘The present study investigated the association between pre-treatment with a cholesterol-lowering drug(statin) or new setting hereon and the effect on the mortality rate in patients with acute ischemic stroke who received intravenous systemic thrombolysis. During a 5-year period(starting in October 2008), 542 consecutive stroke patients who received intravenous systemic thrombolysis with recombinant tissue plasminogen activator(rt-PA) at the Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany, were included. Patients were characterized according to statins. The primary endpoint was mortality;it was assessed twice: in hospital and 3 months after discharge. The secondary outcome was the rate of symptomatic intracerebral hemorrhage. Of the 542 stroke patients examined(mean age 72 ± 13 years;51% women, mean National Institutes of Health Stroke Scale(NIHSS) score 11), 138 patients(25.5%) had been pretreated with statin, while in 190 patients(35.1%) statin therapy was initiated during their stay in hospital, whereas 193(35.6%) never received statins. Patients pre-treated with statin were older and more frequently had previous illnesses(arterial hypertension, diabetes mellitus and previous cerebral infarctions), but were comparably similarly affected by the stroke(NIHSS 11 vs. 11;P = 0.76) compared to patients who were not on statin treatment at the time of cerebral infarction. Patients pretreated with statin did not differ in 3-month mortality from those newly treated to a statin(7.6% vs. 8%;P = 0.9). Interestingly, the group of patients pretreated with statin showed a lower rate of in hospital mortality(6.6% vs. 17.0;P = 0.005) and 3-month mortality(10.7% vs. 23.7%;P = 0.005) than the group of patients who had no statin treatment at all. The same effect was seen for patients newly adjusted to a statin during the hospital stay compared to patients who did not receive statins(3-month mortality: 7.1% vs. 23.7%;P < 0.001). With a good functional outcome(mRS ≤ 2), 60% of patients were
文摘目的观察与探究他汀类药物在短暂性脑缺血发作预防中的效果及对脑血流参数的影响情况。方法选取2016年6月至2017年5月杭州师范大学附属医院收治的80例在短暂性脑缺血发作患者为研究对象,将所有患者按照治疗方式的不同分为对照组和观察组,每组40例。对照组进行常规治疗干预,观察组则在对照组的基础上加用他汀类药物;比较两组患者不同时间短暂性脑缺血发作的发生率、脑梗死发生率及治疗前后的脂代谢指标、脑血流参数、不良反应发生率。结果治疗后不同时间段观察组的短暂性脑缺血发作发生率及脑梗死发生率均低于对照组(χ~2=4.211、6.275、5.698、4.211、5.333、6.135,P均<0.05),治疗前两组的脂代谢指标及脑血流参数(血流速、血流量及相关阻力指标)比较,差异无统计学意义(P>0.05),治疗后观察组的血流速及血流量、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)均高于对照组,相关阻力指标及其他脂代谢指标均低于对照组(P均<0.05),两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论他汀类药物在短暂性脑缺血发作预防中的效果较好,且对患者的脑血流参数具有积极的改善作用,因此在短暂性脑缺血发作患者治疗中有一定的应用价值。
文摘Nephrotic syndrome is a relatively common clinical disease.Associated dyslipidemia is a risk factor for the occurrence and development of cardiovascular and renal diseases that might gradually develop into atherosclerosis,glomerulosclerosis or tubulointerstitial injury.It also confers an elevated risk of complications such as thromboembolism.If not properly controlled over the long term,dyslipidemia will become a key factor in a poor prognosis.Furthermore,dyslipidemia correlates with an increase in hepatic compensatory synthetic lipoprotein levels and a decrease in lipoprotein clearance,which can be sourced to the downregulation of hepatic and lipoprotein lipase activities in endothelial cells,muscle,and adipose tissue,and clinically characterized as hypertriglyceridemia or hypercholesterolemia.However,further investigations into the mechanism(s)of dyslipidemia are needed,with the resultant detailed perspectives and analyses substantially aiding the further development of treatment guidelines.Currently,statins represent the most popular type of pharmaceutical intervention because they lower hepatic cholesterol production and promote the absorption of low-density lipoprotein-cholesterol from the bloodstream,followed by second-line and other potential therapies to regulate the expression of specific receptors.
文摘冠心病严重威胁中老年人的健康。经皮冠状动脉介入治疗是治疗冠心病的方法之一,其创伤小、痛苦少、血管开通率高、出血并发症低等优点,被临床广泛采用。但在手术中对粥样斑块的挤压、血管内膜的撕裂、血小板激活以及促进炎症介质释放等因素引起心肌缺血再灌注损伤进而影响预后。他汀类药物除治疗动脉粥样硬化,还有抗炎、抗氧化、改善内皮功能、改善心肌重构、减少神经内分泌的激活等作用。应用他汀类药物在P C I手术进行缺血后适应发挥保护心肌的作用,对改善患者的预后有着重要的意义。本文对PCI术前应用他汀类药物进行缺血后适应减轻心肌损伤的机制作一综述。