CAJ | 학술논문

目的：调查临床治疗中辛伐他汀和阿托伐他汀与CYP3A4酶抑制剂/诱导剂联合使用的情况。方法：随机抽取某三甲医院2012年度心内科应用辛伐他汀和阿托伐他汀的病例各50份，应用SPSS18.0统计软件，对患者的一般状况、用药情况及化验指标进行统计分析，计算各项指标的平均值或比例。结果：本调查纳入100名患者，66%的患者在使用辛伐他汀或阿托伐他汀的同时使用CYP3A4酶抑制剂，其中，辛伐他汀占30%，阿托伐他汀占36%，平均联合用药时间为（7.04±0.29）d。联合使用的CYP3A4酶抑制剂药物有氨氯地平片、地尔硫片、雷尼替丁片、胺碘酮、银杏叶片；CYP3A4酶诱导剂药物主要有卡马西平和醋酸泼尼松龙片。辛伐他汀或阿托伐他汀与CYP3A4酶抑制剂联合使用频率远远多于与CYP3A4酶诱导剂联合使用频率。比较合用和无合用CYP3A4酶抑制剂患者的主要生化指标，差异无统计学意义（P>0.05）。结论：辛伐他汀或阿托伐他汀与CYP3A4酶抑制剂联合使用情况在该医院较常见。建议尽量避免联用具有相互作用的药物，如必须使用，应按说明书要求不超剂量用药，并充分关注药物相互作用导致的不良反应，对患者后续情况定期随访。
목적：조사림상치료중신벌타정화아탁벌타정여CYP3A4매억제제/유도제연합사용적정황。방법：수궤추취모삼갑의원2012년도심내과응용신벌타정화아탁벌타정적병례각50빈，응용SPSS18.0통계연건，대환자적일반상황、용약정황급화험지표진행통계분석，계산각항지표적평균치혹비례。결과：본조사납입100명환자，66%적환자재사용신벌타정혹아탁벌타정적동시사용CYP3A4매억제제，기중，신벌타정점30%，아탁벌타정점36%，평균연합용약시간위（7.04±0.29）d。연합사용적CYP3A4매억제제약물유안록지평편、지이류편、뢰니체정편、알전동、은행협편；CYP3A4매유도제약물주요유잡마서평화작산발니송룡편。신벌타정혹아탁벌타정여CYP3A4매억제제연합사용빈솔원원다우여CYP3A4매유도제연합사용빈솔。비교합용화무합용CYP3A4매억제제환자적주요생화지표，차이무통계학의의（P>0.05）。결론：신벌타정혹아탁벌타정여CYP3A4매억제제연합사용정황재해의원교상견。건의진량피면련용구유상호작용적약물，여필수사용，응안설명서요구불초제량용약，병충분관주약물상호작용도치적불량반응，대환자후속정황정기수방。
Objective: To investigate the co-administration of simvastatin or atorvastatin with cytochrome P4503A4 (CYP3A4) inhibitors or inducers in clinical treatment. Methods: Fifty cases exposed to the co-administration of simvastatin or atorvastatin with CYP3A4 inhibitors or inducers were selected respectively at random in 2012 in cardiology ward of Beijing Hospital. The basic characteristics, clinical treatment information and laboratory indicators of patients were investigated. The average or proportion of relevant indicators of patients were calculated by SPSS18.0 software. Results:There were 100 patients included in the study. Sixty-six percent of the patients were prescribed simvastatin or atorvastatin with CYP3A4 inhibitors, among which the patients used simvastatin accounted for 30%and atorvastatin accounted for 36%. The average duration of concomitant medication use were (7.04 ± 0.29) days. The CYP3A4 inhibitors that usually combined with simvastatin or atorvastatin were amlodipine, diltiazem, ranitidine, amiodarone, and ginkgo;while the CYP3A4 inducers were carbamazepine, prednisolone acetate tablets. The combination of simvastatin or atorvastatin with CYP3A4 inhibitors was more frequently than that with CYP3A4 inducers. There was no significant difference (P>0.05) when comparing the biochemical indicators of patients who used statins combined with inhibitors or not. Conclusion:The co-prescription of simvastatin or atorvastatin with CYP3A4 inhibitors is common in the hospital. Strategies should be taken to avoid co-administration of simvastatin or atorvastatin with CYP3A4 inhibitors or inducers. If it must be used, drug dosage should be limited according to the direction of drug. We should pay attention to the drug interactions with potential adverse effects, and follow-up patients' condition at regular intervals.