摘要
目的:综合分析他汀类药物对心脏的保护作用。资料来源:应用计算机检索Pubmed2000-01/2005-01有关他汀类药物与冠状动脉粥样硬化性心脏病(冠心病)、心脏保护关系的文献,检索词为“statins,coronaryheartdisease,heartprotection”,并限定语言种类为英文。同时计算机检索万方数据库及CNKL数据库2000-01/2005-01有关他汀类与冠心病、调节血脂、心脏保护关系的文献,检索词为“他汀类,冠心病,心脏药物作用”,并限定语言种类为中文。资料选取:对资料进行初审,选取与他汀类药物和心脏保护效应相关的文献,进一步明确其相关性。选取随机对照研究,实验或临床研究均需包含平行对照组。同一领域的文献,选取近期发表或权威杂志的文章。资料提炼:共检索到54篇关于他汀类药物与心脏保护效应的文献,共14篇文献符合要求。排除的40篇文献中,30篇为非随机研究或重复性研究,10篇为Meta分析文章。资料综合:他汀类药物通过抑制3-羟基-3-甲基戊二酰辅酶A还原酶,使细胞内游离胆固醇减少,加速循环血液中低密度脂蛋白胆固醇和极低密度脂蛋白胆固醇残粒清除,起到降低血脂的作用。并通过改善内皮功能、修复损伤内皮、抑制炎症、稳定易损斑块等非降脂作用,对心脏产生保护效应,从而为冠心病患者一、二级预防提供有力依据。结论:他汀类药物在降脂治疗以及干预心血管危险水平方面的作用已得到肯定,其安全性与耐受性亦经受住了各大规模临床试验的检验。目前,多项他汀类药物强化降脂治疗的临床试验正在进行,其安全性和临床效果有待进一步探索。
OBJECTIVE： To synthetically analyse the protective effects of statins on hearts.
DATA SOURCES： An online search of Pubmed was undertaken to identify English articles about the protective effects of statins on coronary artery disease （CAD） and heart published from January 2000 to January 2005 by using the keywords of ＂statins, coronary artery disease, heart protection＂, Meanwhile, Wanfang and CNKL database were searched with computer for articles about the correlation between statins and CAD, adjustment of cholesterol as well as heart protection published in Chinese from January 2000 to January 2005 by using the keywords of ＂statins, CAD, heart pretection＂.
STUDY SELECTION： Articles were retrieved in the first trial and literatures related to statins and heart protection were selected and further identified for correlations. Randomized control studies were selected and parallel control group should be involved in the experiments or clinical researches. As to literatures in the same region, those published in recent time or published by authorized magzines were selected.
DATA EXTRACTION： A total of 58 articles about the protective effects of statins on heart were collected and 18 literatures were in accordance with the inclusive criteria. Among 40 excluded articles, 30 were non-randomized or repetitive studies, 10 were Meta analysis studies.
DATA SYNTHESIS： By inhibiting HMG-CoA reductase, statins reduced the free cholesterol in cells, accelerated the clearance of low density lipopretein cho/esterel （C-LDL） and very low density lipoprotein cholesterol （C-VLDL） granules, accordingly reduced the blood lipid. Meanwhile statins also had a protective effect on heart by improving endothelial function, restoring injured endothelium, counteracting inflammation, stabilizing vulnerable plaques and so on; Accordingly provided powerful evidences for primary and secondary prevention for patients with CAD.
CONCLUSION： Effects of statins have been confirmed in reducing lipidemia and preven
出处
《中国临床康复》
CSCD
北大核心
2006年第28期129-131,共3页
Chinese Journal of Clinical Rehabilitation
