立普妥产品介绍.pptVIP

* * 立普妥卓越的临床获益，源于它能够提供卓越的降LDL-C疗效。 这是不同剂量他汀降LDL-C幅度比较，该数据来源于对164项他汀类药物研究的荟萃分析。从表中可以看到，立普妥20-40mg使LDL-C下降幅度超过40%，可满足强化降脂需求。而且，立普妥的降LDL-C疗效是其它他汀未能超越的。辛伐他汀和洛伐他汀需要80mg才能使LDL-C降低40%以上，普伐他汀及氟伐他汀在其推荐剂量范围内不能达到降低LDL-C超过40%的强化降脂需求，瑞舒伐他汀在中国批准使用的最大剂量为20mg，降LDL-C幅度为48%，并未超越立普妥的最大降脂幅度。 另外，辛伐他汀最大剂量80mg由于其在A to Z研究中出现9例肌肉不良事件，目前其使用备受争议。 高血脂能使血管内皮细胞发生改变：胆固醇富集区域形成、小凹组织形成增加等。小凹上的主要蛋白成分小凹蛋白（caveolin），能与内皮型一氧化氮合酶（eNOS）结合，降低eNOS活性，从而使内皮功能发生障碍。他汀类药物能减少小凹的形成，增加eNOS活性，继而改善内皮细胞功能。 * * * * 这是对立普妥代谢产物抗氧化作用的一个研究，对立普妥及代谢产物、普伐他汀、瑞舒伐他汀、辛伐他汀和普罗布考的OX-LDL的抑制作用进行比较。 结果显示，立普妥代谢产物对ox-LDL的抑制作用强于其他他汀及立普妥母体，作用甚至强于抗氧化剂普罗布考。 * OBJECTIVES Changes in coronary plaque color and morphology by statin therapy were evaluated using coronary angioscopy. BACKGROUND Coronary plaque stabilization by statin therapy has not been clarified in humans. METHODS Thirty-one patients with coronary artery disease were divided into either the comparison group (n 16) or the atorvastatin group (n 15). Before treatment and 12 months after, the color and complexity of 145 coronary plaques were determined according to angioscopic findings. The yellow score of the plaque was defined as 0 (white), 1 (light yellow), 2 (yellow), or 3 (dark yellow), and its disrupted score was defined as 0 (smooth surface) or 1 (irregular surface) and as 0 (without thrombus) or 1 (with thrombus). In each patient, the mean yellow score and mean disrupted score were calculated. RESULTS Mean low-density lipoprotein cholesterol (LDL-C) decreased by 45% in the atorvastatin group, whereas an increase of 9% was seen in the comparison group. The mean yellow score decreased from 2.03 to 1.13 in the atorvastatin group, whereas it increased from 1.67 to 1.99 in the comparison group. There was a good correlation between the change in the mean yellow score and the change in LDL-C levels (r 0.81, p 0.0001). The change in the mean yellow score and mean disrupted score differed significantly between the two groups (p 0.002 and p 0.03, respectively). CONCLUSIONS This i