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目的探讨住院患者辛伐他汀及阿托伐他汀与人细胞色素P450酶亚型3A4(CYP3A4)抑制剂联用情况。方法随机抽取河源市人民医院2016年应用辛伐他汀及阿托伐他汀的住院病历资料各100份,对患者基本情况、使用他汀类药物和联用CYP3A4抑制剂情况以及相关生化指标进行统计分析。结果 200例使用辛伐他汀和阿托伐他汀患者中,136例患者联用了CYP3A4抑制剂,其中辛伐他汀与CYP3A4抑制剂联用64例(32.0%),阿托伐他汀72例(36.0%);联用CYP3A4抑制剂患者中,联用氨氯地平患者比例最高;联用和未联用CYP3A4抑制剂患者谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酸激酶(CK)、肌酐(Cre)、尿素(Urea)、尿酸(UA)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平差异均无统计学意义(均P>0.05)。结论辛伐他汀和阿托伐他汀与CYP3A4酶抑制剂联用在临床较为普遍,两者之间的代谢性相互作用应引起重视,同时应加强药物安全性监测,以确保用药安全。
Objective To investigate the synergistic effects of simvastatin and atorvastatin on human cytochrome P450 subtype 3A4 (CYP3A4) inhibitor in hospitalized patients. Methods A total of 100 inpatient records of simvastatin and atorvastatin were randomly selected from Heyuan Municipal People’s Hospital in 2016. Statistical analyzes were carried out on the basic information of patients, the statin and CYP3A4 inhibitors, and the relevant biochemical parameters. Results Among the 200 patients who received simvastatin and atorvastatin, 136 patients were treated with CYP3A4 inhibitor, in which 64 patients (32.0%) were treated with simvastatin and CYP3A4 inhibitor, and 72 patients (36.0% %); CYP3A4 inhibitor combined with amlodipine in patients with the highest proportion of patients with and without CYP3A4 inhibitor of glutamate aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase There was no significant difference in CK, Cre, Urea, UA, HDL-C and LDL-C levels (P > 0.05). Conclusions The combination of simvastatin and atorvastatin with CYP3A4 inhibitors is more common in clinical practice. The metabolic interaction between them should be emphasized and drug safety monitoring should be strengthened to ensure drug safety.