瑞舒伐他汀对血浆泛癸利酮浓度的影响与临床合理应用

摘要

目的：研究瑞舒伐他汀对冠心病患者血浆泛癸利酮浓度的影响及临床合理应用。方法筛选符合要求的35例冠心病住院患者，每晚8时给予瑞舒伐他汀钙片10 mg，连续服用12周，分别于服药前、服药4周末、服药12周末测量血浆泛癸利酮浓度、血脂、血糖、肝功能、肾功能，分析服药前、服药4周、服药12周血浆泛癸利酮的浓度与降脂疗效、安全性的相关性，并进行数据统计。结果服药4周、12周与服药前相比血浆泛癸利酮浓度下降42．11％、63．16％，差异有统计学意义（P＜0．01），服药4周末与服药12周末相比，差异有统计学意义（P＜0．05）；服药4周末、12周末与服药前相比血清总胆固醇（TC）分别下降，差异有统计学意义（P＜0．01），服药4周末与服药12周末相比，差异无统计学意义（P＞0．05）；服药4周末、12周末与用药前相比血清低密度脂蛋白胆固醇（LDL-C）分别下降，差异有统计学意义（P＜0．01）；服药4周与服药12周相比LDL-C的差异无统计学意义（P＞0．05）；高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、血尿素氮（BUN）、血肌酐（Cr）、肌酸激酶（CK）、空腹血糖（FBG）服药4周末、12周末与服药前相比差异无统计学意义（P＞0．05）；35例患者服用瑞舒伐他汀12周内未观察到全身性的药物不良事件、检测指标的异常及心血管不良事件。结论常规剂量瑞舒伐他汀能够显著降低血浆泛癸利酮浓度，有效地降低TC、LDL-C水平，血浆泛癸利酮浓度的降低与LDL-C水平有部分相关性，且其安全性好。%Objective To investigate the effects and of Rosuvastatin on the concentration of plasma ubide-carenone and its rationality of clinical use in patients with coronary heart disease. Methods Thirty-five hospitalized patients with coronary heart disease who fulfilled the inclusion criteria were recruited and given 10 mg rosuvastatin calcium tablet at 8 pm every evening for continuous 12 weeks. The plasma ubidecarenone concentration, blood lipids, blood glucose, liver and renal functions were measured respectively before the medication, and at the end of four and twelve weeks after the medication. The correlations among plasma Ubidecarenone concentration, lipid-lowering effica-cy and safety before the medication, four weeks and twelve weeks after the medication were statistical analyzed. Re-sults Plasma Ubidecarenone concentration after 4 weeks and 12 weeks of medication decreased by 42.11% and 63.16%, respectively, compared with those before the medication (P0.05). At the end of these two time points, the serum low density lipoprotein cholesterol (LDL-C) de-creased by 28.34%and 36.44%, respectively, compared with before medication ( P0.05). The high density lipoprotein cholesterol (HDL-C), triglyceride (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum creatinine (Cr), creatine kinase (CK), fasting blood glucose (FBG) at the end of the fourth and the twelfth weeks did not show any change from those before the medication (P>0.05). No systemic drug-related adverse events were ob-served in 35 patients on the 12-week treatment with Rosuvastatin. Conclusion Routine dose of rosuvastatin may sig-nificantly decrease the plasma ubidecarenone concentration, and effectively reduce TC and LDL-C levels. The de-crease in plasma ubidecarenone is concentration partially correlated with the LDL-C level. In addition, plasma ubide-carenone is with good safety profiles.