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降脂药物的肝脏毒性及其防治策略研究进展

徐岩成,  方一杰,  阎澜,  姜远英,  曹永兵

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文章导航 > 药学实践与服务  > 2014 >  32(6): 412-415,464
徐岩成, 方一杰, 阎澜, 姜远英, 曹永兵. 降脂药物的肝脏毒性及其防治策略研究进展[J]. 药学实践与服务, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
引用本文: 徐岩成, 方一杰, 阎澜, 姜远英, 曹永兵. 降脂药物的肝脏毒性及其防治策略研究进展[J]. 药学实践与服务, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
shu
XU Yancheng, FANG Yijie, YAN Lan, JIANG Yuanying, CAO Yongbing. Progress on the hepatotoxicity of lipid-lowering drugs and its prevention strategies[J]. Journal of Pharmaceutical Practice and Service, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
Citation: XU Yancheng, FANG Yijie, YAN Lan, JIANG Yuanying, CAO Yongbing. Progress on the hepatotoxicity of lipid-lowering drugs and its prevention strategies[J]. Journal of Pharmaceutical Practice and Service, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
shu

降脂药物的肝脏毒性及其防治策略研究进展

doi: 10.3969/j.issn.1006-0111.2014.06.004
  • 1.

    福建中医药大学药学院, 福建 福州 350108;第二军医大学药学院, 上海 200433

  • 2.

    第二军医大学药学院, 上海 200433;沈阳药科大学生命科学与生物制药学院, 辽宁 沈阳 110016

  • 3.

    第二军医大学药学院, 上海 200433

Progress on the hepatotoxicity of lipid-lowering drugs and its prevention strategies

  • 1.

    School of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China;School of Pharmacy, Second Military Medical University, Shanghai 200433, China

  • 2.

    School of Pharmacy, Second Military Medical University, Shanghai 200433, China;School of Life Science and Biopharmaceuticals, Shenyang Pharmaceutical University, Shenyang 110016, China

  • 3.

    School of Pharmacy, Second Military Medical University, Shanghai 200433, China

  • 摘要: 肝脏毒性是降血脂药物治疗常见的毒副作用之一,其发生机制尚不完全清楚,大多数降血脂药物的毒副作用都是剂量依赖性的,而且在停药后都有明显的缓解与改善。高龄以及慢性疾病等都是诱发降血脂药物肝脏毒性的潜在因素。降血脂药物的肝脏损伤治疗暂无统一规范,临床应对策略以停药、非特异性保肝和对症治疗为主。研发低毒性或具有保肝作用的降血脂药物,尤其是中药及中药制剂是一个具有良好前景的发展方向。
    Abstract: Hepatotoxicity is one of the most common adverse reactions during anti-hyperlipidemia treatment. Mechanisms of anti-hyperlipidemia drug-induced hepatotoxicity are not clear yet, but most of the toxic reactions are dose-related hypersensitivity and could be released after drug withdrawal. It is accepted that clinical risk factors for the development of hepatotoxicity during anti-hyperlipidemia treatment are high age and chronic illnesses. Treatment of anti-hyperlipidemia drug-induced hepatotoxicity has not been unified and most of the treatments are non-specific and symptomatic. Researching hypotoxicity and hepatoprotection antihyperlipidemia drug, especially TCM and pharmaceutics will become a promising direction.
  • [1] Grundy SM, Cleeman JI, Merz CN,et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines[J]. J Am Coll Cardiol,2004,44(3):720-732.
    [2] Argo CK, Loria P, Caldwell SH, et al. Statins in liver disease: a molehill, an iceberg, or neither?[J]. Hepatology, 2008,48(2):662-669.
    [3] Talbert RL. Safety issues with statin therapy[J]. J Am Pharm Assoc,2006;46(4):479-488.
    [4] Vuppalanchi R, Chalasani N. Statins for hyperlipidemia in patients with chronic liver disease: are they safe?[J]. Clin Gastroenterol Hepatol,2006,4(7):838-839.
    [5] 李光明, 范建高. 慢性肝病患者应用他汀的安全性及疗效[J]. 中华肝脏病杂志,2010,18(5):328-330.
    [6] Cash J, Callender ME, McDougall NI, et al. Statin safety and chronic liver disease[J]. Int J Clin Pract,2008,62(12): 1831-1835.
    [7] Gupta NK, Lewis JH. Review article: the use of potentially hepatotoxic drugs in patients with liver disease[J]. Aliment Pharmacol Ther,2008,28(9): 1021-1041.
    [8] Jimenez-Alonso J, Osorio JM, Guierrez-Cabello F, et al. Atorvastatin-induced cholestatic hepatitis in a young woman with systemic lupus erythematosus[J]. A Arch Intern Med,1999,159(15):1811-1812.
    [9] de Castro ML, Hermo JA, Baz A, et al. Acute cholestatic hepatitis afteratorvastatin reintroduction[J]. Gastroenterol Hepatol,2006,29(1):21-24.
    [10] Nakad A, Bataille L, Hamoir V, et al. Atorvastatin-induced acute hepatitis with absence of cross-toxicity with simvastatin[J]. Lancet,1999,353(9166):1763-1764.
    [11] Gershovich OE, Lyman AE. Liver function test abnormalities and pruritis in a patient treated with atorvastatin: case report and review of the literature[J]. Pharmacotherapy,2004,24(1):150-154.
    [12] Grimbert S, Pessayre D, Degott C, et al. Acute hepatitis induced by HMG-CoA reductase inhibitor, lovastatin[J]. Dig Dis Sci,1994,39(9):2032-2033.
    [13] Vuppalanchi R, Teal E. Chalasani N. Patients with elevated baseline liver enzymes do not have higher frequency of hepatotoxicity from lovastatin than those with normal baseline liver enzymes[J]. Am J Med Sci,2005,329(2):62-65.
    [14] Ricaurte B, Guirguis A, Taylor HC, et al. Simvastatin-amiodarone interaction resulting in rhabdomyolysis, azotemia, and possible hepatotoxicity[J]. Ann Pharmacother,2006,40(4):753-757.
    [15] Kanathur N, Mathai MG, Byrd RP Jr, et al. Simvastatin-diltiazem drug interaction resulting in rhabdomyolysis and hepatitis[J]. Tenn Med,2001,94(9):339-341.
    [16] Caldwell SH, Hespenheide EE, von Borstel RW. Myositis, microvesicular hepatitis, and progression to cirrhosis from troglitazone added to simvastatin[J]. Dig Dis Sci,2001,46(2):376-378.
    [17] Ashar U, Desai D, Bhaduri A. Flutamide-induced hepatotoxicity with possible potentiation by simvastatin[J]. J Assoc Physicians India,2003,51(1):75-77.
    [18] Cornwell PD, De Souza AT, Ulrich RG. Profiling of hepatic gene expression in rats treated with fibric acid analogs[J]. Mutat Res,2004,549(12):131-145.
    [19] Alsheikh-Ali AA, Kuvin JT, Karas RH. Risk of adverse events with fibrates[J]. Am J Cardiol,2004,94(7):935-938.
    [20] Grubisic-Cabo F, Vrdoljak E. Drug-induced hepatitis in a patient with malignant melanoma treated with interferon alfa 2b adjuvantly who had been administered gemfibrozil in therapy[J]. Med Oncol,2006,23(1):121-124.
    [21] Vogt A, Kassner U, Hostalek U, et al. NAUTILUS Study Group. Evaluation of the safety and tolerability of prolonged-release nicotinic acid in a usual care setting: the NAUTILUS study[J]. Curr Med Res Opin,2006,22(2):417-425.
    [22] Henkin Y, Johnson KC, Segrest JP. Rechallenge with crystalline niacin after drug-induced hepatitis from sustained-release niacin[J]. JAMA,1990,264(2):241-243.
    [23] Moon YS, Kashyap ML. Niacin extended-release/lovastatin: combination therapy for lipid disorders[J]. Expert Opin Pharmacother,2002,3(12):1763-1771.
    [24] Coppola A, Brady PG, Nord HJ. Niacin-induced hepatotoxicity: unusual presentations[J]. South Med J,1994,87(1):30-32.
    [25] McKenney J. Niacin for dyslipidemia: considerations in product selection[J]. Am J Health Syst Pharm,2003,60(10):995-1005.
    [26] Stolk MF, Becx MC, Kuypers KC, et al. Severe hepatic side effects of ezetimibe[J]. Clin Gastroenterol Hepatol,2006,4(7):908-911.
    [27] Cruz-Fernandez JM, Bedarida GV, Adgey J, et al. Efficacy and safety of ezetimibe co-administered with ongoing atorvastatin therapy in achieving low-density lipoprotein goal in patients with hypercholesterolemia and coronary heart disease[J]. Int J Clin Pract,2005,59(6):619-627.
    [28] Armani A, Toth PP. Colesevelam hydrochloride in the management of dyslipidemia[J]. Expert Rev Cardiovasc Ther,2006,4(3):283-291.
    [29] Sirmans SM, Beck JK, Banh HL, et al. Colestipol-induced hepatotoxicity[J]. Pharmacotherapy,2001,21(4):513-516.
    [30] Graf D, Kohlmann C, Haselow K, et al. Bile acids inhibit interleukin-6 signaling via gp130 receptor-dependent and independent pathways in rat liver[J]. Hepatology,2006,44(5):1206-1217.
    [31] Brewer HB Jr. High-density lipoprotein: a new potential therapeutic target for the prevention of cardiovascular disease[J]. Arterioscler Thromb Vasc Biol,2004,24:387-391.
    [32] FDA Statement: Pfizer Stops All Torcetrapib Clinical Trials in Interest of Patient Safety[R].2006.
    [33] 彭颂兴, 黎玉容. 药物性肝损伤的病因与临床分析[J]. 临床医药实践,2012,21(8):586-587.
    [34] Kar kiner A,Temir G,Utku M,et al.The efficacy of nonoperative management in childhood blunt hepatic trauma[J]. Ulus Travma Derg,2005,11(2):128-133.
    [35] 王慧铭, 夏道宗, 夏 明,等. 香菇多糖降血脂作用及其机制的研究[J]. 浙江中西医结合杂志,2005,15(10):599-602.
    [36] 狄建彬,顾振纶,赵笑东,等. 姜黄素防治大鼠高脂性脂肪肝的研究[J]. 中草药,2010,41(8):1322-1326.
    [37] 段玉梅,单松波. 降血脂药物开发应用新进展[J]. 黑龙江医药,2004,17(6):449-451.
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  • 收稿日期:  2013-10-29
  • 修回日期:  2014-06-11

降脂药物的肝脏毒性及其防治策略研究进展

doi: 10.3969/j.issn.1006-0111.2014.06.004
  • 1. 福建中医药大学药学院, 福建 福州 350108;第二军医大学药学院, 上海 200433
  • 2. 第二军医大学药学院, 上海 200433;沈阳药科大学生命科学与生物制药学院, 辽宁 沈阳 110016
  • 3. 第二军医大学药学院, 上海 200433
  • 收稿日期: 2013-10-29
  • 修回日期: 2014-06-11

摘要: 肝脏毒性是降血脂药物治疗常见的毒副作用之一,其发生机制尚不完全清楚,大多数降血脂药物的毒副作用都是剂量依赖性的,而且在停药后都有明显的缓解与改善。高龄以及慢性疾病等都是诱发降血脂药物肝脏毒性的潜在因素。降血脂药物的肝脏损伤治疗暂无统一规范,临床应对策略以停药、非特异性保肝和对症治疗为主。研发低毒性或具有保肝作用的降血脂药物,尤其是中药及中药制剂是一个具有良好前景的发展方向。

English Abstract

徐岩成, 方一杰, 阎澜, 姜远英, 曹永兵. 降脂药物的肝脏毒性及其防治策略研究进展[J]. 药学实践与服务, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
引用本文: 徐岩成, 方一杰, 阎澜, 姜远英, 曹永兵. 降脂药物的肝脏毒性及其防治策略研究进展[J]. 药学实践与服务, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
shu
XU Yancheng, FANG Yijie, YAN Lan, JIANG Yuanying, CAO Yongbing. Progress on the hepatotoxicity of lipid-lowering drugs and its prevention strategies[J]. Journal of Pharmaceutical Practice and Service, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
Citation: XU Yancheng, FANG Yijie, YAN Lan, JIANG Yuanying, CAO Yongbing. Progress on the hepatotoxicity of lipid-lowering drugs and its prevention strategies[J]. Journal of Pharmaceutical Practice and Service, 2014, 32(6): 412-415,464. doi: 10.3969/j.issn.1006-0111.2014.06.004
shu

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