附件:他汀类药物用药情况综述【摘要】:目的 目前我国心血管事件发病率和死亡率仍然呈现上升趋势,血脂异常是其中关键危险因素之一,而他汀类药物作为重要控制血脂异常的药物之一。
对其在我国临床应用与不良反应情况进行分析总结,探讨其中问题并针对性提出改善建议。
方法 通过综述基本方法,对比国外情况,对我国他汀类药物用药情况进行分析总结。
结果 由于我国血脂异常知晓率、控制率和达标率低下,应加大力度推动血脂筛查纳入国家基本公共卫生服务项目,从而效地控制血脂水平并提高血脂达标率。
与此同时在使用过程中注意监测,以期减少他汀类药物不良反应发生率,同时进一步提高顺应性。
【关键词】他汀;临床应用;不良反应;【Abstract】Objective At present, China cardiovascular morbidity and mortality are still on the rise, dyslipidemia is one of the key risk factors, and statins as an important control of dyslipidemia drugs. In China its clinical application and adverse reactions were analyzed and summarized, which explore issues and specific recommendations for improvement.Methods Review by the basic method, compared to the situation abroad, to China statin drug use were analyzed and summarized.Result Since the awareness of dyslipidemia, under the control rate and standard rate, should increase efforts to promote lipid screening into the national basic public health services, so as to effectively control blood lipid levels and improve lipid compliance rate. At the same time pay attention to in the course of monitoring, in order to reduce statin incidence of adverse reactions, while further improving compliance..【key words】Statins; Clinical application; Adverse reactions 随着医疗水平不断优化罹患疾病人群增多,加上我国提早进入人口老龄化社会,在多年高血压防控成效下,心血管总死亡率出现下降,但整体发病率仍呈上升趋势,其中缺血性心脏病和缺血性脑卒中发病死亡上升尤其显著1,心血管拐点并未如期到来。
究其原因,血脂异常是其中关键危险因素,国内外指南和大型临床研究一致表明,控制血脂异常危险因素能够带来非常显著临床获益。
而我国在降脂治疗方面仍存在不少误区,患者依从性差,达标率低。
1.1临床应用1.1.1减少胆固醇合成低密度脂蛋白LDL-C是引起动脉粥样硬化和心血管疾病的主要元凶,他汀类药物通过抑制胆固醇合成酶系中的限速酶HMG-CoA还原酶,减少胆固醇合成,降低血清和组织细胞内胆固醇浓度,进而促进浓度依赖的低密度脂蛋白LDL受体活性提高,加速LDL的分解代谢,并能减少极低密度脂蛋白VLDL生成,使VLDL转化成LDL减少,从而降低低密度脂蛋白LDL-C水平。
