合理的积极调脂治疗ppt课件.ppt

* Fig. 3. Inhibiting effects of Fluvastatin on TNFa release in HUVECs stimulated by C-reactive protein (CRP). Cells were preincubated with 10Amol/l of fluvastatin (Flu) for 2 h, and then cells were co-incubated with CRP (50 Ag/ml) or without CRP (control) for 24 h. The concentrations of TNFa in cultured supernatants were measured by ELISA. N=4 for each experiment.The error bars indicate the SD of the mean. *p﹤0.01 compared with CRP group; #p ﹤ 0.01 vs. the control group. CRP stimulation result in induction of TNF-a and activation of NF-nB, and this effect could be significantly inhibited by fluvastatin, suggesting that CRP may play a direct role in atherogenesis by activating endothelial cells, and statins inhibit this response, which may provide an insight into the mechanisms of anti-inflammatory or anti-atherosclerotic actions of statins. TNFa(tumor necrosis factor):肿瘤坏死因子， 参与炎症的反应过程 * Fig. 1. Cumulative curves for survival free atherosclerosis-related adverse cardiac events in patients with either single- or multivessel disease randomized to receive treatment with placebo (upper graph) or fluvastatin (lower graph). Event-free survival distribution was estimated as described in the text, and p values were obtained from the log-rank test. 以40mg普伐他汀为对照 大剂量氟伐他汀导致的肌肉症状最少 临床上常用的经过细胞色素CYP450 3A4 同工酶进行氧化的药物 Emst ,M.EKelly,M.W(1998).Pharmacotherapy 18,463-48 Hoffman,H.S.(1992).Conn.Med 56,107;Modified from Brouwer et al.(1994) 阿托伐他汀 西立伐他汀 洛伐他汀 辛伐他汀 红霉素 非洛地平 利多卡因 奎尼丁 维拉帕米 华法令（主要） 环孢素 硝苯吡啶 氯吡格雷 药物相互作用的风险 对于合并高血压患者， 如同时服用钙离子拮抗剂，辛伐他汀, 阿托伐他汀慎重使用（定期监测CK) 合并房颤等心律失常，辛伐他汀, 阿托伐他汀应在定期监测CK下慎重使用 心衰患者，辛伐他汀, 阿托伐他汀应在定期监测CK及地高辛浓度下慎重使用 PCI术后，联合使用氯吡格雷，辛伐他汀, 阿托伐他汀应在定期监测CK下慎重使用 辛伐他汀, 阿托伐他汀应尽量避免与烟酸类和贝特类药物合用 Emst ,M.EKelly,M.W(1998).Pharmacotherapy 18,463-48 Hoffman,H.S.(1992).Conn.Med 56,107;Modified from Brouwer et al.(1994) 来适可的作用特点及必威体育精装版研究 来适可降低LDL同时， 显著升高HDL 药物 LDL-C HDL-C 甘油三酯 氟伐他汀 80 mg -38% +21% -31% 普伐他汀 40 mg -34%