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抑制剂联用情况分析

Analysis of simvastatin and Atorvastatin Combined with human cytochrome P450 enzyme inhibitor 3A4 in hospitalized patients

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 effect of simvastatin and atorvastatin in patients with human cytochrome P450 enzyme subtype 3A4 inhibitorMethods Randomly selected from the Heyuan People＇s Hospital in 2016 of simvastatin and atorvastatin in the hospital records 100 copies each,the basic situation of the patients using statins and the combined use of CYP3A4 inhibitors and related biochemical indicators for statistical analysis.Results 200 cases of the use of simvastatin and atorvastatin in patients with 136 cases of patients with CYP3A4 inhibitors, including simvastatin and CYP3A4 inhibitor combined with 64 cases（32.0%）,atorvastatin in 72 cases（36.0%）;the combined use of CYP3A4 inhibitors in patients combined with amlodipine combined with the high proportion of patients with and without contact;patients with CYP3A4 inhibitors,glutamic pyruvic transaminase,aspartate amino- transferase,creatine kinase,creatinine,urea,uric acid,high density lipoprotein cholesterol and low density lipoprotein cholesterol levels were not significantly different（P〉0.05）.Conclusion Simvastatin and Atorvastatin Combined with CYP3A4 enzyme inhibitors are more common in clinical practice,and the metabolic interaction between them should be paid attention to.