Lipids,lipid-lowering drug and sepsis:a Mendelian randomization study

lipid-lowering interventions on the disease.Methods:Two-sample Mendelian randomization analyses were conducted to evaluate the associations of high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglycerides,apolipoprotein B and apolipoprotein A-I levels with risks for sepsis,and those of low-density lipoprotein cholesterol(HMGCR,PCSK9,NPC1L1),triglycerides(LPL,ANGPTL3,APOC3)and high-density lipoprotein cholesterol(CETP),apolipoprotein A-I(CETP),apolipoprotein B(HMGCR,PCSK9,NPC1L1,LPL,APOC3)with sepsis.Results:HMGCR-mediated low-density lipoprotein cholesterol and apolipoprotein B were associated with an increased risk of sepsis,with an odds ratio value of 1.4(95%confidence interval(CI):1.06-1.84,P=0.017)and 1.41(95%CI:1.01-1.98,P=0.046).CETP-mediated high-density lipoprotein cholesterol and apolipoprotein A-I were associated with a reduced risk of sepsis,with an odds ratio of 0.87(95%CI:0.82-0.92,P<0.01)respectively and 0.84(95%CI:0.78-0.9,P<0.01).Sensitivity analysis showed that the results were robust.Conclusion:HMG-CoA reductase inhibitors and CETP inhibitors may contribute to the prevention and treatment of sepsis.

Non-steroidal anti-inflammatory drugs and statins in relation to colorectal cancer risk

AIM： To investigate the association between individual or combined use of non-steroidal anti-inflammatory drugs （NSAIDs） or statins and colorectal cancer risk.METHODS： In a population-based case-control study in women, we examined the association between NSAIDs and statin use and the risk of colorectal cancers. We further investigated whether the use of statins modifies the protective effect of NSAIDs. Female cases （n = 669）of colorectal cancer aged 50-74 years were identified from a storewide registry in Wisconsin during 1999-2001. Community control women （n = 1375） were randomly selected from lists of licensed drivers and Medicare beneficiaries. Medication use and risk factor information were gathered during a structured telephone interview. A multivariable logistic regression model was used to calculate odds ratio （OR） and 95% confidence interval （CI）.RESULTS： Overall, NSAIDs users had a 30% reduction in risk of colorectal cancer （95% CI： 0.56-0.88）. Statin use was not associated with colorectal cancer risk （OR = 1.17, 95% CI： 0.74-1.85）, regardless of structural type （lipophilic or hydrophilic）, duration of use, or recency. There was no evidence of an interaction between NSAIDs and statins and colorectal cancer risk （P-interaction = 0.28）.CONCLUSION： Although our results confirm the inverse association between NSAIDs use and colorectal cancer risk, they do not support a risk reduction in statin users, or an interaction effect of combined NSAIDs and statin use.

Role of lipid-lowering agents in the management of diabetic retinopathy

Diabetic retinopathy affects a substantial proportion of patients with diabetes mellitus(DM) and is the leading cause of blindness in working-aged adults. Even though the incidence of diabetic retinopathy has declined in the last decades, its prevalence increased and is expected to rise further as a result of the increasing incidence of type 2 DM(T2DM) and the longer life expectancy of patients with DM. The pathogenesis of diabetic retinopathy is multifactorial. Some observational studies suggested an association between dyslipidemia and the development and progression of retinopathy in patients with DM but others did not confirm this association. Regarding lipid-lowering agents, studies that evaluated the role of statins in the management of these patients are mostly small and yielded discrepant results. Large randomized studies with statins in patients with T2DM showed no benefit of these agents on diabetic retinopathy but were not designed to address this effect. In contrast, both preclinical data and two large randomized controlled studies, the FIELD and the ACCORD trial, showed that fenofibrate delays the progression of diabetic retinopathy. Even though the mechanisms underpinning this favorable effect are not entirely clear, these findings suggest that fenofibrate might represent a useful tool for the management of diabetic retinopathy.

Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett's esophagus

The incidence of esophageal adenocarcinoma,a poor prognosis neoplasia,has risen dramatically in recent decades.Barrett’s esophagus represents the best-known risk factor for esophageal adenocarcinoma development.Non-steroidal anti-inflammatory drugs through cyclooxygenase-2 inhibition and prostaglandin metabolism regulation could control cell proliferation,increase cell apoptosis and regulate the expression of growth and angiogenic factors.Statins can achieve equivalent effects through prenylation and subsequently control of cellular signaling cascades.At present,epidemiological studies are small and underpowered.Their data could not justify either medication as a chemo-preventive agent.Population based studies have shown a 43%reduction of the odds of developing an esophageal adenocarcinoma,leaving out or stating a 25%reduction in patients consuming non-aspirin nonsteroidal antiinflammatory drugs and a 50%reduction in those patients consuming aspirin.They have also stated a 19%reduction of esophageal cancer incidence when statins have been used.Observational studies have shown that non-steroidal anti-inflammatory drugs could reduce theadenocarcinoma incidence in patients with Barrett’s esophagus by 41%,while statins could reduce the risk by 43%.The cancer preventive effect has been enhanced in those patients taking a combination of non-steroidal anti-inflammatory drugs and statins(a 74%decrease).Observational data are equivocal concerning the efficacy of non-steroidal anti-inflammatory drug subclasses.Non-steroidal anti-inflammatory drugs clearly have substantial potential for toxicity,while statins are rather safe drugs.In conclusion,both non-steroidal anti-inflammatory drugs and statins are promising chemopreventive agents and deserve further exploration with interventional studies.In the meanwhile,their use is justified only in patients with cardiovascular disease.

Statins as antifungal agents

Fungal infections are increasing and their treatment is difficult,because the most widely used antifungal drugs are relatively toxic and have serious side effects.Therefore,interest has focused on safely applicable and clinically introduced non-antifungal drugs,which have potent antifungal activity.Statins were originally used as cholesterol lowering agents in human therapy,but recent studies demonstrated their in vitro antifungal activity against yeasts and filamentous fungi.This indicated their potential application,alone or in combination with other drugs,in the treatment of such diseases.Their effective concentrations are higher than their maximum achievable serum levels;therefore,the application of statins for the treatment of invasive fungal infections is only possible in combination with antifungal agents.These synergistic combinations establish a basis for a new safely applicable therapy.This review focuses on the antifungal activity of statins alone and in combination with antifungal and non-antifungal drugs,and their possible application in clinical therapy.

他汀类药物仿制药与原研药的疗效和安全性比较的系统评价

目的:系统评价他汀类药物仿制药与原研药在真实世界中的疗效和安全性,为临床用药选择提供循证依据。方法:计算机检索the Cochrane Library、MEDLINE、Embase、中国知网、中国生物医学文献服务系统、维普数据库和万方数据库,并查阅所获文献所附参考文献,收集他汀类药物仿制药与原研药的观察性研究(暴露组患者使用他汀类药物仿制药或原研药换为仿制药;非暴露组患者使用他汀类药物原研药),检索时限均为数据库建库至2023年7月。对符合纳入标准的研究进行资料提取后,采用纽卡斯尔-渥太华量表进行质量评价;运用RevMan 5.4统计软件进行Meta分析,同时进行描述性分析。结果:共纳入14项研究,其中3项为历史对照研究,11项为队列研究。Meta分析结果显示,仿制药与原研药总体主要不良心血管事件(MACE)发生率的差异无统计学意义(HR=1.07,95%CI=0.98~1.18,P=0.14),但氟伐他汀亚组分析结果提示仿制药的总体MACE发生率显著高于原研药;仿制药的总体全因死亡率显著高于原研药,但随访期为12个月的亚组分析结果显示差异无统计学意义(P>0.05);两组患者脑卒中住院率、不良反应发生率的差异均无统计学意义(P>0.05)。“换药”研究设计的定性描述结果表明,2项回顾性队列研究中,原研药换为仿制药组患者的总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平降低程度与未换药组的差异无统计学意义(P>0.05);3项历史对照研究中,将原研药转换为仿制药并不会降低患者的疗效,然而原研药升高高密度脂蛋白胆固醇的效果显著优于仿制药。结论:他汀类药物的仿制药与原研药在临床疗效和安全性方面未见明显差异。

早期应用他汀类药物对脑梗死患者的治疗效果评价

目的研究脑梗死患者早期给予他汀类药物的疗效。方法目的选取2022年10月—2023年10月潍坊市中医院收治的96例脑梗死患者为研究对象,按治疗方法不同分为两组,对照组采取常规治疗方案,观察组在前组基础上早期给予他汀类药物(阿托伐他汀),比较两组临床疗效、血脂指标和氧化炎症指标。结果观察组的临床总疗效为95.83(46/48),高于对照组的83.33%(40/48),差异有统计学意义(χ^(2)=4.018,P<0.05)。治疗后,观察组总胆固醇、甘油三酯、低密度脂蛋白较对照组更低,高密度脂蛋白较对照组高,差异有统计学意义(P均<0.05)。观察组氧化炎症指标均低于对照组,差异有统计学意义(P均<0.05)。结论脑梗死患者在常规治疗基础上早期给予他汀类药物治疗,可进一步改善血脂指标,降低机体氧化炎症反应,提高治疗效果,具有临床价值。

他汀类药物与骨密度:一项药物靶向孟德尔随机化分析

背景:观察性研究表明他汀类药物可能对骨密度具有保护作用,这使其成为潜在的骨质疏松症治疗药物之一。目的:通过孟德尔随机化方法来评估药物靶点介导的脂质表型与骨密度之间的因果关系。方法:从IEU Open GWAS数据库获取了与他汀类药物相关的单核苷酸多态性以及骨密度相关数据。主要分析方法是逆方差加权法,同时也使用了加权中位数法、简单中位数法、加权中值方法和MR-Egger回归法。使用β值和95%CI来评估他汀类药物与骨密度之间的因果关系;另外,进行敏感性分析以验证结果的可靠性,使用Cochran’s Q检验来评估异质性,使用MR-Egger截距检验是否存在水平多效性。使用留一法分析确定是否有单个或多个单核苷酸多态性影响了结果。结果与结论:他汀类药物作用靶点——3-羟基-3-甲基戊二酰辅酶A还原酶介导的低密度脂蛋白胆固醇与足跟定量超声骨密度(β=-0.086,95%CI:-0.117至-0.055,P=5.42×10^(-8))和全身骨密度(β=-0.193,95%CI:-0.288至-0.098,P=7.35×10^(-5))呈显著相关。该研究结果支持了他汀类药物对骨密度的保护作用。这些发现不仅加深了对胆固醇相关基因和骨骼健康关系的理解,还揭示了改善骨密度的潜在治疗靶点。

他汀类药物的骨靶向递送:联合用药策略与剂量效应关系

传统研究表明,他汀类药物通过影响成骨细胞和破骨细胞的活性对骨代谢产生积极影响。然而,受不良反应和药物疗效的限制,结合纳米技术的骨靶向给药已成为一个新的研究方向。笔者总结了近年来他汀类药物纳米颗粒给药系统的研究情况;纳米技术为未来减少不良反应和提高疗效提供了新的可能性。这些系统利用其精确的药物释放能力有效靶向骨组织,优化疗效并减少全身不良反应。此外,他汀类药物在治疗骨质疏松症时剂量不同的研究也层出不穷。今后,在开发骨靶向给药和纳米技术的组合时,需要考虑他汀类药物的剂量效应关系。总之,他汀类药物在骨质疏松症治疗中的应用是一个多方面的领域,需要综合药物作用机制、剂量效应、纳米技术应用及其临床转化潜力等方面进行深入研究。未来的研究应侧重于探索这些药物的最佳应用,以确保其在调节骨代谢方面的安全性和有效性。

他汀类药物不良反应的临床分析

目的通过分析他汀类药物不良反应报告,为合理使用他汀类药物及不良反应预防提供依据。方法收集从2011-2021年某医院的他汀类药物不良反应报告,依据帕累托分类原则,统计他汀类药物不良反应的类型以及患者的基本情况,分析可能的影响因素以及结局等。结果共收集147例他汀类药物的不良反应报告,他汀类药物不良反应发生人群中55岁以上患者占73.47%;不同年龄合并用药数量:65岁以上为14.29±3.77种,55~65岁为10.50±2.31种;报告中肝损伤占比最高(70.07%),其他还有肌肉、皮肤和神经系统等方面的不良反应;不良反应发生的中位时间为4d;引起不良反应的主要药物为阿托伐他汀40mg·d^(-1)、阿托伐他汀20mg·d^(-1)以及瑞舒伐他汀10mg·d^(-1);多数患者持续时间在9d以内(72.79%);63例患者痊愈(42.86%),71例患者好转(48.30%)。结论使用他汀类药物时,对于55岁以上人群,应尽量精简药物使用种类,避免增加剂量的强化降脂方案,使用4d左右时应注意监测肝功能指标以及其他不良反应,如有发生应及时停药治疗,多数可好转或痊愈。

血脂水平与肿瘤相关性的研究进展

血脂对维持正常的生理稳态至关重要,血脂水平与心血管疾病及癌症的发生、发展和转移密切相关。他汀类药物是常用于调节血脂、抵抗炎症、保护血管内皮和抗血小板凝聚等方面的药物,其抗肿瘤功效和作用也正受到广泛关注。该文对血脂水平与4种常见肿瘤的关系,以及他汀类药物调节血脂水平、抗肿瘤的作用机制进行了综述。他汀类药物在发挥调节血脂水平作用的同时,有望作为肿瘤药物在肿瘤治疗中发挥更大的作用。

Construction and characterization of a humanized SLCO1B1 rat model with its application in evaluating the uptake of different statins

Organic anion-transporting polypeptides IB1(OATPIB1)plays a crucial role in the transport of statins.However,there are too few animal models related to OATPIB1,especially humanized animal models.In this study,the human SLCOIB1 cDNA was inserted into the second exon of the rat Slcolb2 gene using CRISPR/Cas9 technology.Pharmacokinetic characteristics of statins were conducted in wild-type(WT),humanized OATPIB1(hOATPIB1),and OATPIB2 knockout(OATPIB2 KO)rats,respec-tively.The results showed that human OATPIB1 was successfully expressed in rat liver and exhibited transport function.Furthermore,the pharmacokinetic results revealed that OATPIB1 exhibited varying uptake levels of pivastatin,rosuvastatin,and fluvastatin,leading to different levels of exposure within the body.These results were consistent with those obtained from in vitro experiments using overexpressed cell lines.In conclusion,we established a novel humanized SLCOIBI transgenic rat model to assess the role of human OATPIB1 in the uptake of different statins.The different uptake mediated by OATPIB1 may be an important reason for the different efficacy of statins.The hOATPIB1 rat is a promising model for improving the prediction of human drug transport.

丁苯酞联合他汀类降脂药治疗急性脑梗死的疗效及安全性分析

目的:探讨丁苯酞联合他汀类降脂药治疗急性脑梗死的疗效及安全性。方法:选取医院收治的70例急性脑梗死患者,随机分为观察组(35例,采用丁苯酰联合他汀类降脂药以及基础治疗)和对照组(35例,采用西医常规治疗联合他汀类降脂药治疗),对比两组患者总有效率、治疗前后炎症反应状况和神经功能评分改善情况、用药不良反应发生率。结果:观察组患者治疗总有效率明显高于对照组(P<0.05),炎症反应状况和神经功能评分改善情况明显优于对照组(P<0.05);两组患者不良反应发生率的差异无统计学意义(P0.05)。结论:丁苯酰联合他汀类降脂药治疗急性脑梗死具有良好的疗效及较高的安全性。

他汀类与抗血小板聚集药物联合应用于缺血性脑血管病治疗中的效果分析

目的分析他汀类与抗血小板聚集药物联合应用于缺血性脑血管病治疗中的效果。方法104例缺血性脑血管病患者,根据就诊日期单双号分为对照组和联合组,每组52例。对照组应用抗血小板聚集药物治疗,联合组应用他汀类与抗血小板聚集药物联合治疗。比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、血脂指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、C反应蛋白(CRP)水平、内膜中层厚度(IMT)及临床效果。结果治疗后,联合组患者NIHSS评分(8.73±3.46)分低于对照组的(14.02±4.21)分,Barthel指数(72.72±7.53)分高于对照组的(54.86±6.33)分(P<0.05)。治疗后,联合组患者TG(1.21±0.34)mmol/L、TC(2.70±0.22)mmol/L、LDL-C(1.57±0.38)mmol/L低于对照组的(1.59±0.52)、(3.63±0.58)、(2.12±0.49)mmol/L,HDL-C(1.86±0.72)mmol/L高于对照组的(1.59±0.48)mmol/L(P<0.05)。治疗后,联合组患者CRP(2.07±0.39)mg/L、IMT(0.63±0.14)mm低于对照组的(5.46±1.26)mg/L、(0.85±0.19)mm(P<0.05)。联合组临床总有效率为94.23%,高于对照组的80.77%(P<0.05)。结论缺血性脑血管病治疗中采用他汀类和抗血小板聚集类药物联合治疗可提高神经功能、日常生活能力,改善血脂水平,从而帮助患者获得更为满意的疗效和预后。

调脂药物靶点与高血压肾病风险:一项药物靶向孟德尔随机化分析

目的评估调脂药物靶点所介导的脂质表型(HMGCR、PCSK9和NPC1L1)与高血压肾病风险之间潜在的因果相关性。方法使用来自欧洲人群公开可获得的全基因组关联研究(GWAS)汇总数据进行孟德尔随机化(MR)分析。采用与低密度脂蛋白胆固醇(LDL-C)相关的遗传变异,根据选定的调脂药物靶基因筛选工具变量,使用逆方差加权法作为主要MR分析方法,并进行敏感性分析确保结果的稳健性。结果基因预测的LDL-C水平与较高的高血压肾病风险相关(OR=1.19,95%CI:1.03~1.38,P=0.021)。较高的HMGCR介导的LDL-C水平与高血压肾病风险存在正向因果相关性(OR=4.08,95%CI:2.86~5.81;P<0.001)。然而,PCSK9和NPC1L1介导的LDL-C水平与高血压肾病风险无相关性。Cochran Q检验、MR-PRESSO检测和MR-Egger截距测试显示工具变量之间不存在异质性或水平多效性。结论HMGCR介导的LDL-C与高血压肾病的发病风险存在因果相关性,针对HMGCR基因的他汀类药物在高血压肾病的防治中可能具有潜在益处。

Reduced esophageal cancer incidence in statin users,particularly with cyclo-oxygenase inhibition

AIM:To examine the association between statin use and the development of esophageal cancer METHODS:We performed a systematic review and meta-analysis.Multiple databases(Pubmed,EMBASE,Cochrane Library,Web of Science,Wiley Interscience and Google Scholar) were systematically searched for studies reporting the association of statin use and the development of esophageal cancer.Literature searching and data abstraction were performed independently by two separate researchers.The quality of studies reviewed was evaluated using the Newcastle-Ottawa Quality assessment scale.Meta-analysis on the relationship between statin use and cancer incidence was performed.The effect of the combination of statin plus a cyclo-oxygenase inhibitor was also examined.RESULTS:Eleven studies met eligibility criteria,9 high and 2 medium quality.All were observational studies.Studies examining adenocarcinoma development in Barrett's esophagus included 317 cancers and 1999 controls,population-based studies examining all esophageal cancers included 371203 cancers and 6083150 controls.In the Barrett's population the use of statins(OR = 0.57;95%CI:0.43-0.75) and cyclo-oxygenase inhibitors(OR = 0.59;95%CI:0.45-0.77) were independently associated with a reduced incidence of adenocarcinoma.Combined use of a statin plus cyclooxygenase inhibitor was associated with an even lower adenocarcinoma incidence(OR = 0.26;95%CI:0.1-0.68).There was more heterogeneity in the population-based studies but pooled adjusted data showed that statin use was associated with a lower incidence of all combined esophageal cancers(OR = 0.81;95%CI:0.75-0.88).CONCLUSION:Statin use in patients with Barrett's oesophagus is associated with a significantly lower incidence of adenocarcinoma.The chemopreventive actions of statins,especially combined with cyclooxygenase inhibitors deserve further exploration.

Merger of Ezetimibe and Statin:a Potential Dual Inhibitor

A potential dual inhibitor（4） for exogenous absorption and endogenic synthesis of cholesterol was designed based on the conjugation of the β-lactam pharmacophore of ezetimibe and the δ-lactone pharmacophore of statins. The merger of ezetimibe and statin 4 was synthesized from p-hydroxybenzaldehyde through a ten-step route. 1H NMR analysis showed existence of four pairs of enantiomers（5.7：5.7：1：1, molar ratio）. And compound 4 was found to lower total glucose（TG） level in rat serum via a high-cholesterol and high-fat feeding experiment.

Paracelsus Paradox and Drug Repurposing for Cancer

Dose is one of the parameters that any pharmacologist seriously considers when studying the effects of a drug.If the necessary dose to achieve a desired pharmacological effect is in a toxic or very toxic range for human use,the drug will probably fall out from further research.The concentration that a drug can reach to its target organ or cell is a direct consequence of the administered dose and its pharmacodynamic properties.Basic researchers investigate at the cellular level or eventually with xenografts.They use different concentrations of the drug in order to determine its cellular effects.However,in many cases,these concentrations require doses that are in the toxic range or well beyond any clinically achievable level.Therefore,in these cases,research is in the realm of toxicology rather than therapeutics.This paper will show some examples about this exercise in futility which is time and resource consuming but that pullulates the pages of many prestigious journals.Many seasoned researchers seem to have forgotten the Paracelsus Paradox.

9城市老年患者使用他汀类药物潜在药物相互作用分析

目的对老年患者处方中他汀类药物的潜在药物相互作用进行分析。方法抽取2016年至2021年9座城市160余家医院使用他汀类药物的老年患者门诊处方,根据Lexicomp药物相互作用数据库筛查存在的D类及X类的药物相互作用。同时根据最新版他汀类药物说明书中针对合并用药推荐的每日最大剂量,筛选超出该推荐剂量的处方。使用sql server 2019及R 4.2软件进行数据处理、Logistic回归及其他统计学分析。结果共收集2733777例次门诊处方,涉及7种他汀类药物,筛查出潜在相互作用37584例次,整体发生率为1.38%。多因素二元Logistic回归分析显示,相对于男性,女性(OR=1.18,95%CI 1.16~1.21,P<0.001)的潜在药物相互作用风险更高;相对于65~74岁患者,75~84岁(OR=1.03,95%CI 1.01~1.05,P<0.05)患者风险略增加,85~94岁(OR=0.96,95%CI 0.93~0.99,P<0.05)患者风险略降低,95岁及以上患者差异无统计学意义;相对于合用2种药物的患者,随着合用药数量的增加风险增加:3种(OR=2.23,95%CI 2.12~2.34,P<0.001),4种(OR=3.24,95%CI 3.10~3.40,P<0.001),5种(OR=4.15,95%CI 3.96~4.34,P<0.001),5种以上(OR=5.47,95%CI 5.23~5.72,P<0.001)。结论老年患者使用他汀类药物时存在发生潜在药物相互作用的风险,临床工作者需要给予足够的重视。

国家药品集中采购政策下他汀类药物和依折麦布的应用分析

目的分析药品集中采购(以下简称集采)政策对他汀类药物和依折麦布应用情况的影响。方法回顾性收集首都医科大学附属北京安贞医院医院信息系统中2018—2022年的门诊高胆固醇血症患者调脂药物使用数据,利用药物经济学方法分析各他汀类药物的价格、数量、金额、用药频度(DDDs)和日用药金额(DDC)等变化情况,并关注阿托伐他汀钙片集采仿制药和原研药与依折麦布联合使用情况。结果药品集采政策实施后,他汀类原研药品使用量占比下降,集采仿制药使用量占比上升,2020年和2021年阿托伐他汀钙片中选仿制药(10 mg×14片/盒、20 mg×14片/盒)从第4位上升至第2位;2021年瑞舒伐他汀钙片中选仿制药(10 mg×14片/盒)替换中选仿制药(10 mg×28片/盒),至2022年其DDDs稳居第3位,而原研药DDDs已降为第4位。药品费用有明显的下降,集采后中选仿制药阿托伐他汀钙片(10 mg×7片/盒、20 mg×7片/盒)和(10 mg×14片/盒、20 mg×14片/盒)的DDC分别仅为原研药的15.38%、3.27%;瑞舒伐他汀钙片中选的仿制药(10 mg×28片/盒、10 mg×14片/盒)的DDC最低仅为原研药的4.33%、5.42%;辛伐他汀片中选的仿制药(20 mg×60片/盒)DDC仅为原研药的5.20%。另外联用依折麦布使用比例上升明显。结论药品集采政策实施后中选仿制药使用量占比上升,显著降低了高胆固醇血症患者的用药经济负担。