中国药物警戒 ›› 2019, Vol. 16 ›› Issue (1): 43-46.

• 安全性评价与合理用药 • 上一篇    下一篇

药物相互作用对阿托伐他汀安全性和有效性的影响分析

张宏1,3, 贾娜2, 张亚同3, 胡欣3,*   

  1. 1北京大学药学院药事管理与临床药学系,北京 100191;
    2北京医院心内科/国家老年医学中心,北京 100730;
    3北京医院药学部/国家老年医学中心,北京 100730
  • 收稿日期:2018-07-08 修回日期:2019-02-18 出版日期:2019-01-20 发布日期:2019-02-18
  • 通讯作者: 胡欣,男,博士,主任药师,临床药学。E-mail：huxinbjyy@126.com
  • 作者简介:张宏,女,在读硕士,临床药学。

Analysis of Effects of Drug-drug Interactions on Safety and Efficacy of Atorvastatin

ZHANG Hong1,3, JIA Na2, ZHANG Yatong3, HU Xin3,*   

  1. 1Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China;
    2Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China;
    3Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
  • Received:2018-07-08 Revised:2019-02-18 Online:2019-01-20 Published:2019-02-18

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摘要： 目的 研究在老年冠心病患者中,合用CYP3A4酶的底物或抑制剂对阿托伐他汀使用安全性及有效性的影响。研究与阿托伐他汀引起肌病风险相关的危险因素。方法 提取某三甲医院2017年3月到6月所有使用阿托伐他汀的老年冠心病患者的临床数据,对数据进行提取整理并用SPSS进行分析,相关的危险因素分析用多元线性回归的方法。结果 对于老年冠心病患者,阿托伐他汀与CYP3A4抑制剂合用,对阿托伐他汀的有效性及安全性指标没有显著地影响。但是随着与阿托伐他汀合用的CYP3A4底物数量的增加,CRE值有逐渐升高的趋势。多元线性回归分析显示,与服用阿托伐他汀引起肌病（CK值升高）风险相关的因素有：年龄、性别、血脂异常和合用CYP3A4抑制剂。结论 对于阿托伐他汀合用CYP3A4抑制剂和多种CYP3A4底物的老年患者,注意监测患者的安全性指标,特别是CRE和CK值。

关键词: 阿托伐他汀, 相互作用, CYP3A4, 安全性, 有效性, 肌病

Abstract: Objective To study the safety and efficacy of atorvastatin in elderly patients with CAD when combined with substrates and inhibitors of CYP3A4, so as to find out the risk factors associated with atorvastatin-induced myopathy. Methods The clinical data of elderly patients, who had received atorvastatin, were collected in one research center from March to June in 2017 and analyzed by SPSS. The associated risk factors were analyzed by multivariate linear regression analysis. Results There was no significant effect on the safety and efficacy of atorvastatin for elderly patients with CAD, combined with the inhibitors of CYP3A4. However, with the increasing number of the substrates of CYP3A4, CRE showed a rising tendency. According to the result of multivariate linear regression analysis, CK could be influenced by age, gender, dyslipidemia, and the inhibitors of CYP3A4 in elderly patients with CAD. Conclusion The safety parameters should be monitored when elderly patients received atorvastatin and in combination with CYP3A4 inhibitors and multiple CYP3A4 substrates, especially the CRE and CK.

Key words: atorvastatin, drug-drug interaction, CYP3A4, safety, efficacy, myopathy

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