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Atorvastatin

内分泌

关键词内分泌 治疗药物 降胆固醇药物

词汇介绍

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解析

atorvastatin   英/ə,tɔrvə'stætn/ 

       n. 阿托伐他汀(降血脂药)

       Atorvastatin can suppress the expression and release of inflammatory mediator by adipose tissue and endothelial cells. 阿托伐他汀可通过脂肪组织及内皮细胞抑制炎症介质的分泌及表达。

概述

阿托伐他汀(立普妥)是一种用来降低血清胆固醇的药物,胆固醇(和甘油三酸酯)可在体内转化为脂肪。虽然身体需要一些胆固醇,但过多的胆固醇对机体的健康是没有益处的。具体而言,胆固醇是在肝脏中制造,降低“坏”胆固醇和甘油三酯以及提高“好”胆固醇降低患心脏病的风险并有助于预防中风和心脏病这种药物还可以降低糖尿病患者心脏病发作或中风的风险。适应症①原发性高胆固醇血症(高胆固醇)和混合性血脂异常;②高甘油三酯血症(高甘油三酯);③原发性半胱氨酸蛋白血症;④纯合家族性高胆固醇血症;⑤心血管疾病预防。不良反应

A Multicenter, Randomized, Placebo-Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis复制标题

阿托伐他汀用于类风湿关节炎患者心血管事件一级预防的多中心、随机、安慰剂对照试验

发表时间:2019-09-01

影响因子:9.0

作者: George D Kitas

期刊:Arthritis Rheumatol

Despite major advances in therapy over the last two decades, rheumatoid arthritis (RA) continues to be associate d with reduced life expectancy compared to the general population. Almost half of all deaths in RA (about 35-40% of the excess deaths) are attributed to cardiovascular disease (CVD). There are many mechanisms that may underlie Accepted Article This article is protected by copyright. All rights reserved. the increased CVD morbidity and mortality in RA but their crosstalk and relative contribution s are not yet fully elucidated. CVD risk factors including smoking, hypertension, dyslipidemia, increased adiposity, and reduced physical activity are highly prevalent in RA but do not account fully for the excess CVD. A significant part is attributed to “novel” CVD risk factors, such as ‘high -grade’ inflammation promoting atherothrombotic cardiovascular events (CVE). Risk algorithms developed for the general population may underestimate CV E risk in patients with RA, even when multipliers are applied, as in recently updated European recommendations. This makes identification of RA patients who would benefit from primary prevention therapy less precise, leads to significant underuse of statins even in patients who fulfil general population thresholds for statin treatment and has led some to suggest universal prescription of statins in RA, as practiced in diabetes mellitus (DM). The efficacy of statins in the primary and secondary prevention of CVE has been demonstrated in large -scale trials and meta -analyses. CVE reduction is related to the degree of low density lipoprotein cholesterol (LDLc) reduction. Each mmol/L reduction in LDLc is associated with a 20-22% lowering of the risk of myocardial infarction (MI), revasculari zation and stroke. In RA, high -grade inflammation is associate d with a suppression of total cholesterol (TC), LDL c and high density lipoprotein cholesterol (HDLc) levels, as well as changes in lipid structure and function promoting atherosclerosis. The potential pleiotropic anti-inflammatory/immunomodulatory effect s of statins may therefore be more relevant in RA than in the general population. In the TARA trial, atorvastatin 40mg daily, as an adjunct to disease modifying anti-rheumatic drug (DMARD) therapy, provided a modest additional benefit for inflammatory control of RA, at least in a subgroup of patients, while the Tayside controlled study of rosuvastatin in RA suggested a potentially Accepted Article This article is protected by copyright. All rights reserved. beneficial effect on C-reactive protein (CRP) levels. The extent to which statins affect lipid levels and reduce CVE in RA remain s uncertain, due to the small number of RA patients included in general population trials.

译文

尽管在过去二十年中治疗取得了重大进展,但与一般人群相比,类风湿性关节炎(RA)仍然与预期寿命降低有关。 RA中几乎一半的死亡(约占死亡人数的35-40%)归因于心血管疾病(CVD)。有许多机制可能成为接受文章的基础本文受版权保护。版权所有。 RA中CVD发病率和死亡率增加但其串扰和相对贡献尚未完全阐明。包括吸烟,高血压,血脂异常,肥胖增加和体力活动减少在内的CVD危险因素在RA中非常普遍,但并未完全解释过量的CVD。很大一部分归因于“新型”CVD危险因素,例如“高级”炎症促进动脉粥样硬化血栓性心血管事件(CVE)。针对一般人群开发的风险算法可能会低估RA患者的CV E风险,即使应用乘数也是如此,如最近更新的欧洲建议。这使得能够从初级预防治疗中受益的RA患者的鉴定不太精确,即使在达到他汀类药物治疗的一般人群阈值的患者中也导致他汀类药物的显着未充分使用,并导致一些人建议在RA中普遍使用他汀类药物,如糖尿病一样。 mellitus(DM)。他汀类药物在CVE的一级和二级预防中的功效已在大规模试验和荟萃分析中得到证实。 CVE降低与低密度脂蛋白胆固醇(LDLc)降低程度有关。 LDLc中每mmol / L的降低与心肌梗塞(MI),血运重建和中风风险降低20-22%相关。在RA中,高度炎症与总胆固醇(TC),LDL c和高密度脂蛋白胆固醇(HDLc)水平的抑制以及脂质结构和促进动脉粥样硬化的功能的变化相关。因此,他汀类药物的潜在多效抗炎/免疫调节作用可能在RA中比在一般人群中更具相关性。在TARA试验中,每日40mg阿托伐他汀作为改善抗风湿药物(DMARD)治疗的辅助手段,为RA的炎症控制提供了适度的额外益处,至少在患者亚组中,而泰赛德对照研究瑞舒伐他汀RA中提出可能被接受的文章本文受版权保护。版权所有。对C-反应蛋白(CRP)水平的有益作用。由于一般人群试验中包括少量RA患者,他汀类药物影响脂质水平和降低RA中CVE的程度仍然不确定。