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Clinical Observation of Atorvastatin in 70 Patients with Hyperlipidemia

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。

Clinical Investigation on Treating Arteriosclerotic Cerebral Infarction Combined with Hyperlipemia by Prubucol

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500mg 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。

Relationship between dyslipidemia and diabetic retinopathy in non-insulin-dependent diabetes mellitus

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 lowdensity lipoprotein （LDL） and very lowdensity 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)

Xuezhikang Capsule for Hyperlipidemia: A Systematic Review

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bank, and Chinese Biomedical Database(CBM), China Hospital Knowledge Database(CHKD) were searched，and the published/unpublished information was handsearched (updated to Dec., 2005) to identify randomized controlled trials (RCTs) or quasi-RCT of XZK versus statins or other lipid lowering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.

高脂血症急性胰腺炎临床特点回顾性分析

目的探讨高脂血症急性胰腺炎（HLAP）的临床特征及治疗。 方法回顾性分析2011年3月至2013年12月期间在笔者所在医院治疗的25例HLAP患者的临床资料，并与同期128例胆源性胰腺炎（ABP）患者进行对比研究。 结果HLAP组患者年龄偏年轻、男性多于女性，在体质量指数、合并糖尿病的比例、复发率、病情严重程度及血糖上明显高于ABP组（P<0.05），甘油三酯明显升高（P<0.01）；ABP组血尿淀粉酶水平较HLAP组明显升高（P<0.05）。 结论HLAP多发生于年轻的男性肥胖患者，常合并有糖尿病，具有重症胰腺炎发病率高、血甘油三酯高和血尿淀粉酶低的不同于ABP的临床特点。采用血液净化等治疗，可降低其病死率。

胸腔积液及高脂血症对重症急性胰腺炎发生的预测作用

目的探讨胸腔积液、高脂血症与重症急性胰腺炎（SAP）早期诊断的关系。 方法2010年1月-2014年3月对入院24 h内的120例急性胰腺炎患者按2013年《中国急性胰腺炎诊治指南》的诊断标准分为SAP组（68例）和轻症急性胰腺炎（MAP）组（52例）。两组均行胸腹部CT及血脂分析检查，记录胸腔积液、高脂血症以及胸腔积液并高脂血症与SAP发病例数、病死率、腹水、肝功能不全、胰腺假性囊肿的关系。 结果SAP组与MAP组胸腔积液分别为57例（83.8%）和12例（23.1%），高脂血症分别为52例（76.5%）和17例（32.7%），胸腔积液并高脂血症分别为47例（69.1%）和7例（13.5%），差异有统计学意义（P＜0.001）。SAP组患者中，是否并发胸腔积液者病死率、胰腺假性囊肿发生率差异无统计学意义（P＞0.05），并发胸腔积液者腹水、肝功能不全发生率发生率高于无胸腔积液者（P＜0.05）；是否合并高脂血症者病死率、胰腺假性囊肿发生率差异无统计学意义（P＞0.05），合并高脂血症者腹水和肝功能不全发生率均高于未合并高脂血症者（P＜0.05）；是否同时合并胸腔积液和高脂血症者胰腺假性囊肿发生率差异无统计学意义（P＞0.05），同时合并胸腔积液和高脂血症者病死率、腹水发生率、肝功能不全发生率均高于未同时合并胸腔积液和高脂血症者（P＜0.05）。 结论胸腔积液、高脂血症与SAP发生有密切关系，同时还与部分并发症有关，检测这两项指标，对SAP早期诊断及并发症的早期干预有意义。

Effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis

Objective To study the clinical protective effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis (HLSAP). Methods Thirty-seven patients with HLSAP treated between January 2012 and December 2014 were selected and divided into three groups based on different treatments. Thirteen patients were allocated into hemoperfusion combined with continuous veno-venous hemofiltration group (HP+CVVH group) and treated with hemoperfusion combined with hemofiltration; 11 patients were allocated into continuous veno-venous hemofiltration group (CVVH group) and treated with hemofiltration; and all the other patients were allocated into control group and treated with conventional treatment. The levels of blood triglyceride, C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and acute physiology and chronic health evaluation (APACHE)Ⅱ score of the patients after treatment were observed. The hospital stay, organ dysfunction rate and mortality of the patients were measured. Results Compared with the control group, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group and CVVH group were both significantly reduced 72 hours after therapy (P<0.05). However, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group were significantly lower than those in the CVVH group at the same time point (P<0.05). The hospital stay of the patients in the HP+CVVH group and CVVH group was significantly shorter than that in the control group (P<0.05). Compared with the CVVH group, the hospital stay of patients in the HP+CVVH group was significantly shorter (P<0.05). There was no statistical difference in organ dysfunction rate and mortality among the three groups (P>0.05). Conclusion Hemoperfusion combined with hemofiltration is an effective method for HLSAP by cleaning the inflammatory mediators availably and inhibiting the excessive inflammatory reaction.

Probucol for non-proliferative diabetic retinopathy with hyperlipidemia

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.

Research on Practice Effect of WeChat Software on the Treatment Compliance of Patients with Hyperlipidaemia

ObjectiveTo investigate the practice effect of WeChat on the treatment compliance of patients with hyperlipidaemia in general out-patient department. MethodsFrom June 2012 to May 2013, 178 patients with hyperlipidaemia who could use WeChat software were selected. The patients were randomly divided into the control group (87 patients) and experimental group (91 patients). All the patients were treatment with routine nursing intervention. The experimental group was giving nursing intervention based on WeChat. After 180 days, the compliance score and serum lipid level of the patient were tested and analyzed. ResultsThe score in experimental group on the treatment compliance were as follows:diet:6.57±0.78, take medicine:8.64±1.13, exercise:5.11±0.97, and return visit:5.75±0.74; the percentage effective control of lipid level was 93.4%. The score of the control group on the treatment compliance were as follows diet:4.63±1.23, take medicine:6.91±0.73, exercise:3.98±0.54, and return visit:4.86±0.39; the percentage effective control of lipid level was 57.5%. The difference in the results between two groups is significant (P<0.05). ConclusionApplying WeChat software on nursing intervention for patients with hyperlipidaemia may increase the treatment compliance and enhance the control of serum lipid level.

家族性高脂血症患者罹患冠状动脉粥样硬化性心脏病行冠状动脉旁路移植术一例