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他汀类可导致精力减退或劳力性疲劳
作者: 时间:2012-06-14 点击:374 来源:网络来源
<SPAN style="FONT-FAMILY: 宋体; COLOR: #3d3d3d; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt; mso-bidi-font-size: 10.5pt"><FONT size=3><FONT color=#3d3d3d><SPAN lang=EN-US><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p> <DIV> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">环球医学据悉,加州大学圣迭戈分校的研究人员在一项涉及</SPAN><SPAN lang=EN-US><FONT face=Calibri>1000</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">多名成年人的研究中发现,服用他汀类降脂药的患者比不服用者更容易出现精力减退和</SPAN><SPAN lang=EN-US><FONT face=Calibri>/</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">或劳力性疲劳。研究人员认为,医生在权衡使用他汀类药物的利弊时,应当考虑以上结果。</SPAN><FONT face=Calibri> <SPAN lang=EN-US><o:p></o:p></SPAN></FONT></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">他汀类药物是市场上最畅销和使用最广泛的处方药。近来,人们越来越关注他汀类药物的副作用,特别是其对运动的影响。尽管曾有一些患者在服用他汀类药物时报告过疲劳或运动不耐受,但以往的随机试验并未就劳力性疲劳或精力减退对他汀类药物与安慰剂进行比较。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">加州大学圣迭戈分校医学院的医学副教授、医学博士、哲学博士</SPAN><SPAN lang=EN-US><FONT face=Calibri>Beatrice Golomb</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">及其同事们在《内科学文献集》中提交的一项随机试验的数据显示,服用他汀类药物者的这些副作用显著多于服用安慰剂者。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN lang=EN-US><FONT face=Calibri>1000</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">多名来自圣地亚哥的成年人被随机分配服用安慰剂,或两种相对低效力的他汀类药物之一:普伐他汀(普拉固)</SPAN><SPAN lang=EN-US><FONT face=Calibri>40 mg</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">,或辛伐他汀(舒降之)</SPAN><SPAN lang=EN-US><FONT face=Calibri>20 mg</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">,前者为水溶性最强的他汀,后者为脂溶性最强的他汀,预计两者按以上剂量服用可产生相近的</SPAN><SPAN lang=EN-US><FONT face=Calibri>LDL</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">(“坏胆固醇”)降幅;以上安慰剂或药物均以相同的胶囊包装。据研究人员介绍,研究中胆固醇的降幅预计与服用</SPAN><SPAN lang=EN-US><FONT face=Calibri>10mg </FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">阿托伐他汀(立普妥)或</SPAN><SPAN lang=EN-US><FONT face=Calibri>2.5-5 mg</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">瑞舒伐他汀(可定)相近。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">心脏疾病和糖尿病患者被排除在外。受试者或研究人员均不知道受试者服用的是那种药物。受试者在一个</SPAN><SPAN lang=EN-US><FONT face=Calibri>5</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">分量表(从“非常差”到“非常好”)中评价其精力和劳力性疲劳的情况。服用他汀类药物者比服用安慰剂者更易报告精力减退和</SPAN><SPAN lang=EN-US><FONT face=Calibri>/</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">或劳力性疲劳。以上两种他汀类药物均能导致这些结果,但服用辛伐他汀者的这些作用似乎更强(辛伐他汀降胆固醇的效果更为显著)。“随着剂量的增加,他汀类药物普遍显现出副作用,按照现行的标准,这些为中等剂量,”</SPAN><SPAN lang=EN-US><FONT face=Calibri>Golomb</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">说。“这一问题的发生并不少见,即使是在这些剂量上也是如此,尤其是在女性中。”</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">如果比如说服用辛伐他汀的</SPAN><SPAN lang=EN-US><FONT face=Calibri>10</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">名女性中有</SPAN><SPAN lang=EN-US><FONT face=Calibri>4</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">人表示精力减退或劳力性疲劳、</SPAN><SPAN lang=EN-US><FONT face=Calibri>2</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">人表示两者均有,或两者中任何一个评级为“非常差”;或者如果</SPAN><SPAN lang=EN-US><FONT face=Calibri>10</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">名受试者中</SPAN><SPAN lang=EN-US><FONT face=Calibri>1</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">人的精力和劳力性疲劳评价均为“非常差”,就可从研究结果中看出他汀类药物作用的强度。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 15.75pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 1.5" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">“精力是生活质量的核心。它还可预测活动的兴趣,”</SPAN><SPAN lang=EN-US><FONT face=Calibri> Golomb</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">说。“劳力性疲劳并不仅仅预测实际参与运动的情况,但较差的精力和较大的劳力性疲劳可能预示着一种机制的触发,而他汀类药物或可通过这种机制对细胞健康产生有害影响。”</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P> <P style="LINE-HEIGHT: 150%; TEXT-INDENT: 21pt; MARGIN: 0cm 0cm 0pt; mso-char-indent-count: 2.0" class=MsoNormal><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">基于这些原因,研究人员指出,服用他汀者的精力减退和劳力性疲劳的增加意味着非常重要的发现,对他汀类药物的利弊做出决策时应予以考虑。据</SPAN><SPAN lang=EN-US><FONT face=Calibri>Golomb</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">表示,对于证据并不支持他汀能带来死亡率获益的人群——例如大部分没有心脏疾病的患者和女性及大于</SPAN><SPAN lang=EN-US><FONT face=Calibri>70</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">或</SPAN><SPAN lang=EN-US><FONT face=Calibri>75</FONT></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin">岁者(即使患有心脏疾病),以上结论尤其正确。(环球医学)</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P></DIV></o:p></SPAN></FONT></FONT></SPAN>
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