Objective To systematically review the effectiveness and safety of Zhibitai vs. atorvastatin in the treatment of hyperlipidemia. Methods Randomized controlled trials (RCTs) about Zhibitai vs. atorvastatin for hyperlipidemia were electronically retrieved in databases of PubMed, CENTRAL (Issue 7, 2010), CBM,CNKI, VIP and WanFang Data from inception to July, 2012. Two reviewers independently screened literature, extracted data, and assessed methodological quality. Then, meta-analysis was conducted using RevMan 5.2 software. Results A total of 4 RCTs involving 519 cases were included. The results of meta-analysis showed, Zhibitai was superior to atorvastatin in reducing TG levels after 8-week treatment (MD= −0.12, 95%CI −0.23 to −0.01, P=0.03) and increasing HDL-C levels after 8-week treatment (MD= −0.16, 95%CI −0.22 to −0.11, P=0.000 01). But there was no significant difference in decreasing TC levels and LDL-C levels after 4-week treatment and 8-week treatment as well as decreasing TG levels after 4-week treatment between the two groups. No obvious adverse reaction occurred in the two groups, but atorvastatin may impair liver function. Conclusion Current evidence with weak strength shows that, Zhibitai is superior to atorvastatin in reducing TG levels, and increasing HDL-C levels after 8 weeks. However, they are alike in other blood-fat index and safety. Due to the limited quantity and quality of the included studies, more high quality RCTs are needed to verify the above conclusion.
目的 探讨成都市高脂血症患病率及合并心血管危险因素的现状及城乡差异。 方法 2010年3月-11月随机抽样选取城市和农村社区,采用问卷、体格检查和实验室检查共调查35~70岁人群2 032例,其中城市社区1 015例,农村社区1 017例。进一步调查其中高脂血症患者合并的主要心血管危险因素。 结果 ① 成都市城乡高脂血症患病率为23.53%(474/2 032)。城市高于农村,分别为27.88%(283/1 015)和18.78%(283/1 017);② 城市高脂血症人群中合并高血压、糖尿病和冠心病均高于农村。高脂血症合并高血压人群最多,城乡分别是51.95%(147/283)和31.94%(61/191),其次是合并“糖尿病”和“冠心病”人群;③ 城市高脂血症患者合并高血压人群无论男女均高于农村,但城市男性合并糖尿病者高于农村,城市女性合并冠心病者高于农村;④ 城乡高脂血症患者在合并饮酒、脑卒中史、腹型肥胖和肥胖之间差异无统计学意义(P<0.05)。 结论 高血压、糖尿病和冠心病是城市高脂血症患者干预的重点危险因素。其中城市男性的糖尿病和城市女性冠心病干预更为重要。
目的:探讨氟伐他汀(fluvastatin)治疗高脂血症患者的疗效分析。方法:对50例确诊动脉粥样硬化血脂异常的患者,以氟伐他汀40 mg/d,治疗6个月。用药前后测TC、TG、LDL-C和HDL-C,采用自身对照开放试验对比其疗效。结果:50例患者治疗前后,TC、TG和LDL-C分别降低了10.9%、39.6%和28.2%,HDL-C上升了0.24±0.09 mmol/L,前后对比差异均有统计学意义(Plt;0.05)。结论:氟伐他汀治疗高脂血症患者具有良好的调脂作用。
Objective To observe the effectiveness of probucol for non-proliferative diabetic retinopathy (NPDR) with hyperlipidemia. Methods Fifty-two patients (104 eyes) of NPDR with hyperlipidemia were enrolled in this study. The patients were randomly divided into treatment group and control group, 26 patients (52 eyes) in each group. Both groups received diet and exercise guidance, oral hypoglycemic agents and (or) intensive insulin therapy. After blood sugar and blood pressure were controlled, the treatment group received probucol 0.5 g, two times per day; and the control group received atorvastatin of 10 mg, one time per day. The total course was 12 months. Before and after one, three, six and 12 months, all patients underwent vision, ophthalmoscope, fundus fluorescein angiography, blood and urine tested. Variations of visual acuity, fundus condition, macular edema, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC) and 8-0HdG were observed before and after treatment. Results The total effective rate of visual prognosis were 44.23% and 40.38% in the treatment group and the control group, the difference had no statistical significacy (Z=-0.335, P>0.05). Retinal hemorrhages and microaneurysms alleviated after treatment in both groups.The total efficiency of fundus prognosis was 65.38% in the treatment group and 36.54% in the control group, and the difference was statistically significant (Z=-2.973,P<0.05). Macular edema was in six and five eyes in the treatment group and the control group respectively, which were lower than before treatment, the difference was statistically significant (chi;2=4.833, 4.300;P<0.05). Between the two groups, the difference was not statistically significant (chi;2=0.102,P>0.05). Twelve months after treatment, TG, TC and LDLC were decreased in the treatment group (t=15.653, 7.634, 14.871) and control group (t=13.275, 7.415, 13.632), and the difference was statistically significant (P<0.05). HDLC showed no significant difference than before in the two groups (t=0.584, 0.275;P>0.05). TG, TC, LDLC and HDLC showed no difference between the two groups (t=1.857, 0.133, 1.671, 0.875;P>0.05). 8-0HdG decreased gradually during the one, three, six and 12 months in the treatment group (t=7.352,15.581, 27.324, 28.143) and control group (t=6.877, 8.672, 14.671, 14.855) after treatment, and the difference was statistically significant (P<0.05). In the first month after treatment, 8-0HdG showed no difference between the two groups (t=0.513,P>0.05). In the 3, 6, and 12 months after treatment, the 8-0HdG was lower in the treatment group than that in the control group, and the difference was statistically significant (t=3.434, 5.917, 5.226;P<0.05). Conclusion In the treatment of NPDR with hyperlipidemia, probucol can reduce blood lipid, stable visual function and relieve macular edema.
Objective To investigate the relationship between dyslipidemia and diabetic retinopathy in non-insulin-dependent diabetes mellitus(NIDDM) patients. Methods In 55 health controls,60 NIDDM patients with DR and 75 NIDDM patients without DR,the plasma total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL)and HDL subfractions,fasting plasma glucose(FPG),fasting plasma insulin(FINS)and glycosylated hemogolbin(HbA 1C)were measured,and the plasma lowdensity lipoprotein (LDL) and very lowdensity lipoprotein(VLDL)were caculated. Results In NIDDM patients with DR,the TC,LDL,FPG,HbA 1C and duration of NIDDM were higher or longer than those in NIDDM patients without DR.Moreover,the TC,LDL,FPG、FINS、HbA 1C and dutation of NIDDM were increased or lengthened in NIDDM patients with proliferative DR as compared with those with backgroud DR.The correlation analysis showed the severity of DR was positively correlated with TC,LDL,HbA 1C and duration of NIDDM. Conclusion Dyslipidemia may play some role in the onset and development of DR. (Chin J Ocul Fundus Dis,1998,14:21-23)
Objective To assess the efficacy and safety of Xuezhikang capsule (XZK) for hyperlipidemia. Methods MEDIINE,EMBASE, Cochrane Central Register of Controlled Trials(CCTR), Cochrane Metabolic and Endocrine Disorders Group data bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched,and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering drugs in treating hyperlipidemia patients. The quality evaluation, data extraction and analysis were conducted by the method recommended in Cochrane Reviewer’s Handbook 4.2.2. Data were analyzed using Review Manager (Version 4.2). Results Eleven trials (conducted in China) were identified, including 1 073 patients with hyperlipidemia met the inclusion criteria. All the included RCTs were graded as B or C. ① The effect of XZK in reducing TC: There were no significant differences between XZK and statins ( WMD 0.06, 95%CI-0.09 to 0.20 and RR1.02, 95%CI 0.93 to 1.12), XZK and fibrates (WMD 0.05, 95%CI -0.22 to 0.31) and XZK and probucol(WMD 0.42, 95%CI -0.01 to 0.85). XZK was superior to hexanicit (WMD 0.96, 95%CI 0.73 to 1.18). ② The effect of XZK in reducing TG: XZK had the same effect as statins (WMD 0.02, 95%CI -0.10 to 0.14 and RR 1.17, 95%CI 0.92 to 1.49) and hexanicit (WMD 0.28, 95%CI -0.17 to 0.73 ).Meanwhile, XZK was superior to probucol (WMD 0.71, 95%CI 0.22 to 1.20), but it was not as good as fibrates (WMD -0.81, 95%CI -1.40 to -0.23). ③ The effect of XZK in increasing HDL-C:XZK had the same effect as that of statins (WMD -0.03, 95%CI -0.10 to 0.04 and RR 1.03, 95% CI 0.80 to 1.33). The effect of XZK was better than that of hexanicit (WMD 0.15, 95%CI 0.01 to 0.29). XZK had the same effect of fibrates (WMD 0.03, 95%CI -0.08 to 0.15) and probucol (WMD 0.04, 95%CI -0.16 to 0.24). ④ The effect of XZK in reducing LDL-C:The effects of XZK and statins were the same (WMD -0.23, 95%CI -0.61 to 0.15 and RR 1.15, 95%CI 0.75 to 1.77). The effect of XZK was better than that of hexanicit (WMD 0.53, 95%CI 0.16 to 0.90). Meanwhile, XZK had the same effect as those of fibrates (WMD 0.19, 95%CI -0.12 to 0.50) and probucol (WMD 0.35, 95%CI -0.03 to 0.73). ⑤ The adverse reactions of XZK were mainly the gastrointestinal tract reaction, while liver function abnormality and myalgia were scarcely found. Conclusion Xuezhikang capsule have the same effects as those of statins in reducing the levels of TC, TG, LDL-C and raising HDL-C in patients with hyperlipidemia. No obvious adverse reactions are found during the short-term treatment. But further confirmation with clinical randomized controlled trials of high quality, large sample and long-term follow-up is needed.
目的:探讨阿托伐他汀治疗高脂血症患者的疗效分析。方法: 对70例确诊高脂血症的患者给予阿托伐他汀10 mg,每日一次,连服3个月,观察观察治疗前后的血脂、肝功能、肾功能,同时观察患者有无不良反应。结果:治疗3个月后,TC、TG、LDL-C均较治疗前显著下降(Plt;0.05),HDL-C较治疗前明显提高(Plt;0.05),TC、TG、LDL-C、HDL-C治疗3个月的总有效率分别是84.28%、74.6%、80%和62.26%,未见明显不良反应。结论:阿托伐他汀治疗高脂血症患者安全有效。
目的:比较伴或不伴高脂血症的系统性红斑狼疮(SLE)患者的狼疮性肝损害的构成比例,了解高脂血症与狼疮性肝损害的相关性。方法:收集SLE患者100例,根据高脂血症和狼疮性肝损害的诊断标准,将患者分为高脂血症组,非高脂血症组和肝损害组,非肝损害组,收集其相关临床数据进行比较分析。结果:1高脂血症组发生肝损害的比例高于非高脂血症组(χ2=9.908,P=0.002);2血脂水平中甘油三酯与γGT(r=0366,P=0.000),碱性磷酸酶(r=0.241,P=0.018),强的松剂量(r=0.31,P=0.006),24h尿蛋白定量(r=0.273,P=0.007)相关;TC与24h尿蛋白定量(r=0.273,P=0.007)相关;HDL与γ谷氨酸转肽酶(r=0.233,P=0.022),碱性磷酸酶(r=0.265,P=0.009)相关;3-SLE活动组出现高脂血症的比例高于非活动组(χ2=6.986,P=0.008)。结论:长期的高脂血症可导致或加重SLE患者肝功能损害,高脂血症是狼疮性肝损害的危险因素之一。
目的:探讨普罗布考对动脉粥样硬化性脑梗死并高脂血症患者血脂及预后的影响。方法:将87例脑梗死并高脂血症患者随机分为两组,治疗组44例,对照组43例,两组除按动脉粥样硬化性脑梗死常规治疗外,停用一切降脂药物。治疗组给予普罗布考500mg bid/d。疗程为6个月。随访一年观察两组患者治疗后血脂水平及脑血管事件发生情况。结果:治疗组患者治疗前、后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)间差异均有显著性意义(Plt;0.05)。两组患者治疗后各项血脂指标间差异均有显著性意义(Plt;0.05)。随访一年,显示治疗组患者心脑血管事件14次,对照组19次(Plt;0.05)。结论:普罗布考降脂疗效可靠、副作用轻微,降低心脑血管事件发生。可作为动脉粥样硬化性脑梗死并高脂血症患者的一、二级预防药物。