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OBJECTIVE:To observe the clinical efficacy and safety of ezetimibe combined with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia. METHODS:90 patients with membranous nephropathy complicated with hyperlipidemia were randomly divided into observation group and control group,45 cases in each group. All patients received health guidance,low-fat diet,and the drugs without interfere with regulating lipid,hepatoprotective and lipid metabolism were for-bid. Control group was orally given 20 mg Simvastatin tablet,qd;observation group was additionally given 10 mg Ezetimibe tab-let,qd. They were treated for 8 weeks. Clinical efficacy was observed,lipid levels [total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C)],aspartate aminotransferase (AST),ala-nine aminotransferase(ALT),urinary protein quatitation,creatine kinase(CK)before and 2,4,8 weeks after treatment,and the incidence of adverse reactions were compared. RESULTS:Total effective rates of membranous nephropathy and hyperlipidemia were 95.56% and 93.30% in observation group,which were significantly higher than 73.33% and 75.56% in control graup,with statistical significance (P0.05);after 8 weeks of treat-ment,TC level in observation group was significantly lower than control group,the differences were statistically significant (P0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Ezetimibe shows similar clinical efficacy with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia,it can effectively reduce TC level,with good safety.
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Objective To explore the cost-effectiveness analysis of zhibituo and simvastatin in treatment of hyperlipemia. Methods 68 cases with hyperlipemia were divided into two groups randomly:group A were treated with imvastatin (n = 33),group B were treated with zhibituo(n = 35). The data was evaluated with eost-effectiveneas analysis. Results The cost of the two groups was 462.56 yuan and 257.60 yuan respectivdy. The effective rate was 74.28 % and 73.9.3 %respectivdy. The cost-effectiveness ratio was 6.23 and 3.48 respectively. The increased cost-effectiveness ratio of group A vs group B was 585.6. No significant differences were found in both effective rate and ADRS between two groups(P＞0.05).Conclusion Zhibituo was an effective and safe drug in treating hyperlipidemia as well as simvastatin. But zhibituo was better than simvastatin based on the oost-effeetiveness analysis.
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Objective To investigate the impact of simvastatin on blood lipid and the incidence of atrial fibrillation and ischemic-related events in patients with acute myocardial infarction accompanied by paroxysmal atrial fibrillation. Methods One hundred and three patients with acute myocardial infarction and paroxysmal atrial fibrillation were selected as subjects, and were divided into a simvastatin group and a control group. Forty-five patients were in the simvastatin group, who took simvastatin 20mg/d orally for 18 months; fifty-eight patients were in the control group, and received conventional therapy except for statins. All patients were followed up for 18months. The level of blood lipid, recurrence rate of paroxysmal atrial fibrillation, incidence rate of persistent or permanent atrial lipids did not change significantly in the control group (P＞0.05); concentrations of total cholesterol (TC) and low density lipoprotein five patients during 18 months follow-up in the simvastatin group (11.1%), whereas it occurred in 14 patients of the control group(24.1%, P＜0.05); the occurrence rate of persistent or permanent atrial fibrillation in the simvastatin group was 4.4%, which was lower than (6.6%), two rehospitalizations for deterioration of coronary heart diseases (4.4%), three cardiac deaths (6.6%), and one cerebral stroke (2.2%), which was lower evidently than in the control group (41.4%, P＜0.05). Conclusions Simvastatin can not only decrease the levels of serum TC and LDL-C but also prevent the occurrence of atrial fibrillation and ischemic-related events.
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Objective To compare the effects of every-other-day dose simvastatin administration with that of daily therapy of same dose.Methods This was a randomized,prospective,nonblinded clinical trial.The 186 patients with high low-density lipoproteim cholesterol(LDL-C) and/or high total cholesterol (TC),triglycerides (TG),low high-density lipoprotein cholesterol(HDL-C)was studied.All patients were randomized into two groups.The every-other-day do- sing group recerived 20mg of simvastatin in alternate-day and daily dosing group received 20mg of simvastatin every day.Before and after 6 weeks,12 weeks of treatment,serum lipoprotein,Live function tests and ereatine kinase con centra- tion and so on were drawn and bad-side effect were studies.Results The two groups significantly reduce LDL-C,TC, TG and a little increased HDL-C compared with baseline.No stalistically significant differences existed between the two groups in percentage in decrease in lipoprotain at 6 weeks,12 weeks compared with baseline.The bad-side effect in the two groups also had not a singnificant different.Conclusion The every-other-day dose of simvastatin have similar effi- cacious and safe to daily dosing in patients with hyperlipidemia and some cost savings.It can take a primary prevention to coronary heart disease in patients with relatively low-risk hyperlipidemia.
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AIM: To investigate the effects of simvastation on homocysteine-induced endothelial dysfunction and inflammatory response and the underlying mechanisms of such effects. METHODS: MTT assay was used to detect cell viability, and DCFH-DA assay was used to examine the levels of reactive oxygen species (ROS). Furthermore, Western blotting was performed to detect protein expression and electrophoretic mobility shift assay (EMSA) was used to detect NF-?B DNA binding activity. RESULTS: Homocysteine (0.1-1 mmol/L) decreased the human umbilical vein endothelial cell (HUVEC) viability and increased the levels of ROS. Western blotting and ELISA showed that homocysteine significantly increased the expression of TNF-?, IL-6, MCP-1 and ICAM-1. However, pretreatment with simvastation (1-20 ?mol/L) reversed the decreased cell viability and markedly suppressed an increase in the ROS level and the expression of TNF-?, IL-6, MCP-1 and ICAM-1 induced by homocysteine. Homocysteine induced p38 phosphorylation and such phosphorylation was also inhibited by simvastation and antioxidant NAC. EMSA and Western blotting showed that homocysteine induced NF-?B activation due to the increased phosphorylation of the inhibitory protein (I?B?) as well as the degradation of I?B?, while simvastation pretreatment almost completely blocked the NF-?B activation as well as the phosphorylation and degradation of I?B?. CONCLUSION: Simvastation inhibits homocysteine-induced endothelial dysfunction and inflammatory response through interfering with ROS-p38-NF-?B pathway.
