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.
目的:探討普羅布考對動脈粥樣硬化性腦梗死并高脂血癥患者血脂及預后的影響。方法:將87例腦梗死并高脂血癥患者隨機分為兩組,治療組44例,對照組43例,兩組除按動脈粥樣硬化性腦梗死常規治療外,停用一切降脂藥物。治療組給予普羅布考500mg bid/d。療程為6個月。隨訪一年觀察兩組患者治療后血脂水平及腦血管事件發生情況。結果:治療組患者治療前、后總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)間差異均有顯著性意義(Plt;0.05)。兩組患者治療后各項血脂指標間差異均有顯著性意義(Plt;0.05)。隨訪一年,顯示治療組患者心腦血管事件14次,對照組19次(Plt;0.05)。結論:普羅布考降脂療效可靠、副作用輕微,降低心腦血管事件發生。可作為動脈粥樣硬化性腦梗死并高脂血癥患者的一、二級預防藥物。
目的：探討阿托伐他汀治療高脂血癥患者的療效分析。方法： 對70例確診高脂血癥的患者給予阿托伐他汀10 mg，每日一次，連服3個月，觀察觀察治療前后的血脂、肝功能、腎功能,同時觀察患者有無不良反應。結果：治療3個月后,TC、TG、LDL-C均較治療前顯著下降(Plt;0.05),HDL-C較治療前明顯提高(Plt;0.05),TC、TG、LDL-C、HDL-C治療3個月的總有效率分別是84.28%、74.6%、80%和62.26%,未見明顯不良反應。結論：阿托伐他汀治療高脂血癥患者安全有效。
Objective To study the influence of hyperlipemia on rats with acute pancreatits during pregnancy and its mechanism. Methods Seventy two pregnant Sprague-Dawley rats were randomly divided into the test group and the control group， and then they were fed with high fat diet and balanced diet for 16 days separately. Pregnant rats were given intraperitoneal injection with L-arginine for 2 times (one time is 250 mg/100 g, the other is 200 mg/100 g) at an interval of 1 h. The serum triglyceride (TG), serum amylase (AMS), and lipase (LPS) from blood samples were tested just after injection, and 12 h， 18 h， 24 h， 30 h and 48 h after injection respectively, and wet/dry ratio of pancreas were measured. The histopathological score of pancreatic tissue was evaluated based on microscopic changes, and the expression of TNF-α protein was determined by SP immunohistochemical technique. Results After the last injection, the level of TG in the test group was obviously higher than that in the control group in each time (P＜0.05). The peak values of AMS and LPS in the test group appeared at 24， 18 h respectively, while the peaks appeared at 30， 24 h in the control group, respectively, which were significantly lower than those in the test group (P＜0.05). Compared with the control group, the wet/dry ratio of pancreas in the test group increased at 12, 18 and 24 h after injection (P＜0.05); The pathological changes of pancreas in test group was more serious with higher histopathological score at 0, 12, 18 and 24 h (P＜0.05), and expression of the TNF-α protein was higher at 12, 18 and 24 h (P＜0.05), too. Conclusion Hyperlipemia can make L-arginine-induced-acute-pancreatitis during pregnancy earlier occur and lead to more serious injury in pancreas. This study demonstrates that hyperlipemia may be a high risk factor for acute pancreatitis during pregnancy, making a great amount of free fatty acid released from TG and up-regulated the expression of TNF-α.
In recent years, the incidence of hyperlipidemia acute pancreatitis (HLAP) has been increasing year by year, but its pathogenesis has not been completely clear. There are many clinical treatment methods for HLAP, such as lipid-lowering drugs, low molecular weight heparin, insulin, and plasma exchange. Actively reducing serum triglyceride is the core of treatment. Plasma exchange can quickly and effectively reduce the level of triglyceride, and its application in the treatment of HLAP is gradually increasing. This article reviews the recent advances in the pathogenesis, clinical characteristics, diagnosis, and treatment of HLAP, focusing on the mechanism, indications, timing, and disadvantages of plasma exchange therapy for HLAP.
ObjectiveTo systematically review the effect and safety of continuous veno-venous hemofiltration (CVVH) on patients with hyperlipidemic pancreatitis. MethodsDatabases including the Cochrane Library (Issue 2, 2014), PubMed, EMbase, CBM, CNKI and WanFang Data were electronically searched for randomized controlled trials (RCTs) about CVVH on patients with hyperlipidemic pancreatitis till Feb. 12, 2014. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 7 trials met eligibility criteria, involving 360 cases, including 183 cases of CVVH group and 177 cases of control group. The results of meta-analysis showed that compared with only routine medical treatment, CVVH significantly reduced the levels of lipid (WMD=-4.63, 95%CI-5.98 to-3.27, P < 0.000 01), levels of IL-6 (WMD=-29.59, 95%CI-34.30 to-24.89, P < 0.000 01), overall mortality (RR=0.39, 95%CI 0.18 to 0.84, P=0.02), and APACHE II score (WMD=-3.34, 95%CI-5.12 to-1.56, P=0.000 2) after treatment. ConclusionCVVH is more effective for hyperlipidemic pancreatitis than only routine medical treatment. Due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are required to verify the above conclusion.
目的:探討氟伐他汀（fluvastatin）治療高脂血癥患者的療效分析。方法:對50例確診動脈粥樣硬化血脂異常的患者，以氟伐他汀40 mg/d，治療6個月。用藥前后測TC、TG、LDL-C和HDL-C，采用自身對照開放試驗對比其療效。結果:50例患者治療前后，TC、TG和LDL-C分別降低了10.9%、39.6%和28.2%，HDL-C上升了0.24±0.09 mmol/L，前后對比差異均有統計學意義（Plt;0.05）。結論:氟伐他汀治療高脂血癥患者具有良好的調脂作用。