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JAMA Neurology:他汀类药物预防阿尔兹海默病?服用2年降低15%的患病率

2016-12-15 生物探索 生物探索

导读 他汀类药物能够预防阿尔兹海默症?近期,《JAMA Neurology》期刊最新刊出一篇学术文章揭示,他汀类药物能够对大脑产生积极的影响,连续服用2年能够显著降低老年人患老年痴呆症的概率。

导读 他汀类药物能够预防阿尔兹海默症?近期,JAMA Neurology期刊最新刊出一篇学术文章揭示,他汀类药物能够对大脑产生积极的影响,连续服用2年能够显著降低老年人患老年痴呆症的概率。



他汀类药物是降脂类降胆固醇、高脂血症领域的典型药物,其减缓动脉粥硬化的功效奠定了其在心血管疾病治疗中的重要地位。

来自于南加州大学的研究团队近期,发现除了心血管疾病,他汀类药物还有望应用于预防阿尔兹海默症。他们耗时7年(从2006年至2013年),对40万名美国老年人(65岁以上)进行调研分析。结果显示,他汀类药物能够对大脑产生积极的影响,女性服用这一廉价药物能够降低15%的患病率,男性能够降低12%。

Julie Zissimopoulos教授带领团队分析了调研对象是否服用他汀类药物、服用规律以及阿尔兹海默症患病等数据。总体而言,他们发现,每年会有1.72%的女性和1.32%的男性被确诊为阿尔兹海默症患者。但是,他汀类药物却鞥能够显著降低这一风险,且随着服药时间的延长,患病风险会进一步下降。

研究人员推测,胆固醇可能参与了淀粉样蛋白病斑的形成过程,而他汀类药物能够清理胆固醇,这有利于血液流向大脑,从而有助于抵制神经细胞的死亡。

他们发现,不同类型的他汀类药物对不同性别、种族的人有着不同的治疗效果,例如辛伐他汀(Simvastatin)会降低白人、西班牙裔和黑人女性以及白人、西班牙裔男性患痴呆症的风险。但是,对于黑人男性而言,任何类型的他汀类药物在预防痴呆风险上都没有显著差异。

Julie Zissimopoulos表示:“尽管经历了多年的研究,科学家们仍未研发出能够延缓甚至于逆转老年痴呆的药物。现在,这一最新数据意味着我们或许已经触摸到一个有效治疗手段,他汀类药物可以作为候选药物,用于降低阿尔兹海默症的风险。”

阿尔兹海默症协会研究主任Doug Brown博士评价这一最新研究表示:“”如此庞大的数据足以表明他汀类药物与老年痴呆症的关联性。但是,现有的数据并没有提供直接的证据,表明他汀类药物确实能够影响老年痴呆风险,这一结论仍然需要临床试验证实。

原始出处:


[2] Julie M. Zissimopoulos, PhD,et al. Sex and Race Differences in the Association Between Statin Use and the Incidence of Alzheimer Disease.  JAMA Neurol.December 12, 2016.

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在证据存在争议的情况下,也为临床医生提供一个实践医学艺术和在心血管疾病的预防策略上与患者共同决策的机会。

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合并分析的证据表明他汀类药物可提高心脏移植者的生存率,而且还可以预防致命的排斥反应,减少晚期癌症风险,降低冠状动脉病变的发生率。需要进一步的前瞻性研究,来进一步调查和解释这种相关性。

J Thromb Haemost:他汀类药物可以降低复发性静脉血栓形成风险

根据一项以人群为基础的队列研究的结果,对于既往发生过静脉血栓形成的患者,使用他汀类药物可以降低复发性静脉血栓形成的风险。 华盛顿大学流行病学系教授Nicholas L. Smith博士称:虽然抗凝治疗可有效的预防血栓复发,但长期治疗存在大出血风险。如果能寻找到既不增加出血风险,又可以降低复发风险的替代方法就是提高临床管理的关键。 因此他们进行了研究,评估他汀类药物能否降低复发性静脉血栓

AHA 2016:他汀类药物能改善心脏骤停患者的生存结局

根据在美国心脏协会科学会议上发表回顾性队列研究结果,对于院外心脏骤停患者,心脏骤停前使用他汀类药物与不使用他汀类药物比较,患者有更好的生存结局。 研究人员报告说,在糖尿病患者中,这种影响是特别明显的。 来自台湾的研究人员Ping-Hsun Yu博士和同事推测,心脏骤停前使用他汀类药物可能会改善结局,因为他汀类药物具有多效性,包括减少炎症相关的损伤和内皮功能障碍。 研究纳入了137

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