Statin tedavilerinin iskelet kası, anksiyete, depresyon ve yaşam kalitesi üzerine etkileri
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Dosyalar
Tarih
2012
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hiperlipidemi tedavisinde özellikle de LDL kolesterolün düşürülmesinde en etkili, en yaygın kulanılan Hidroksimetilglutaril-koenzim A inhibitörlerin (statinler)çok sayıda çalışmada koroner arter hastalığında mortalite ve morbiditeyi azalttığı,son çalışmalarda da inmeyi önlemede faydalı olduğu bulunmuştur. Kontrollü klinik çalışmalara göre statinler oldukça iyi tolere edilebilmekle birlikte, miyalji, kramp,güçsüzlük gibi semptomlardan kas kuvvet kaybı, rabdomiyolize kadar ilerleyebilen miyopatiye neden olabilmektedir. Ancak statin tedavisi alan hastalarda müskülerperformansın incelendiği çok az sayıda çalışma vardır.Çalışmamızın amacı iki farklı statin tedavisinin diz izokinetik kas gücü,anksiyete, depresyon, yaşam kalitesi üzerine ve müsküler yan etkilerini araştırmaktır. Hiperkolesterolemi tanılı 63 hasta üç ay süreyle 20 mg/gün atorvastatin ve 20mg/gün rosuvastatin tedavisi almak üzere iki gruba randomize edildi. Tedavi öncesi ve sonrası hastaların dominant dizin izokinetik kas kuvvet ölçümleri yapıldı. Müsküler yan etkiler, serum kreatin kinaz, karaciğer fonksiyon testleri, anksiyete,depresyon ve yaşam kalitesi ölçekleri değerlendirildi.Atorvastatin grubunda %12.5, rosuvastatin grubunda %9.6 oranında müsküler yan etki saptadık. Diz izokinetik kas gücü ölçümlerinde; atorvastatin grubunda 60°/s hızda fleksiyonda ve ekstansiyonda total iş ve 180°/s hızda ekstansiyon pik torkdeğerlerinde, rosuvastatin grubunda ise 60°/s hızda fleksiyonda ve ekstansiyonda total iş değerlerinde istatistiksel anlamlılıkta azalma belirledik. Her iki grupta diz izokinetik kas gücünde azalma saptanan hastaların % 8-10'unda müsküler semptom bulduk. Beck Anksiyete, Beck Depresyon ve Nottingham Sağlık Profili ölçekleri ile değerlendirilen her iki grup hastalarda tedavi öncesi ve tedavi sonrası arasındaistatistiksel anlamlılıkta fark yoktu. Sonuç olarak statin tedavisi alan hastalarda risk faktörleri, müsküler şikayetler ve serum kreatin kinaz yüksekliği olmasa da düzenli kontrollerle kas gücü değerlendirmesi yapılmasının faydalı olacağı bu nedenle statin tedavisi alan hastaların tedavileri başlamadan önce ve tedavileri devam ederken en az üçer aylıkperiyotlarla fiziyatristler tarafından da takip edilmesi gerektiği sonucuna vardık.
Statins are the most effective medications for reducing elevatedconcentrations of lowdensity lipoprotein cholesterol. Numerous studies have demonstrated that cholesterol lowering with statin therapy reduces morbidity and mortality from coronary heart disease and also useful in preventing stroke. Statins have been extremely well-tolerated in controlled clinical trails but can produce a skeletal myopathy with symptoms ranging from mild complaints such as myalgia,cramps, and weakness to rhabdomyolysis. Muscle performance has not been carefully examined in statin users.The aim of the study was to investigate the effects of different two statins on knee isokinetic skeletal muscle strength, patients anxiety, depression, quality of life and also muscle adverse effects of statins. We conducted the study on 63 patients who had been randomly assigned to treatment with 20 mg/day atorvastatin or rosuvastatin for three months. Patients dominant knee isokinetic muscle strength was tested and also their liver and creatine kinase measurements, muscle-related adverse reactions, anxiety, depression and quality of life levels were evaluated before and after treatment.Muscle related adverse reactions were reported by 12.5% of atorvastatin group and 9.6% ofrosuvastatin group. After treatment; in both group total work values in flexion and extension by 60°/s speed, and extension peak torque by 180°/s speed in atorvastatin group statistically reduced compared to values before treatment. İn both groupmuscle symptoms were found in 8-10% of the patients who had reduction in knee isokinetic muscle strength after treatment. There was no statistically difference in both groups anxiety, depression and life quality questionnaire between before andafter treatment. As a result, the muscle strenght of patients treated with statins should be evaluated regularly although they had no muscle complain, elevated creatine kinaselevels and also risk factor. So patients who received statin therapy should be concluded by physiatrists before starting and continued treatment for at least three months following periods.
Statins are the most effective medications for reducing elevatedconcentrations of lowdensity lipoprotein cholesterol. Numerous studies have demonstrated that cholesterol lowering with statin therapy reduces morbidity and mortality from coronary heart disease and also useful in preventing stroke. Statins have been extremely well-tolerated in controlled clinical trails but can produce a skeletal myopathy with symptoms ranging from mild complaints such as myalgia,cramps, and weakness to rhabdomyolysis. Muscle performance has not been carefully examined in statin users.The aim of the study was to investigate the effects of different two statins on knee isokinetic skeletal muscle strength, patients anxiety, depression, quality of life and also muscle adverse effects of statins. We conducted the study on 63 patients who had been randomly assigned to treatment with 20 mg/day atorvastatin or rosuvastatin for three months. Patients dominant knee isokinetic muscle strength was tested and also their liver and creatine kinase measurements, muscle-related adverse reactions, anxiety, depression and quality of life levels were evaluated before and after treatment.Muscle related adverse reactions were reported by 12.5% of atorvastatin group and 9.6% ofrosuvastatin group. After treatment; in both group total work values in flexion and extension by 60°/s speed, and extension peak torque by 180°/s speed in atorvastatin group statistically reduced compared to values before treatment. İn both groupmuscle symptoms were found in 8-10% of the patients who had reduction in knee isokinetic muscle strength after treatment. There was no statistically difference in both groups anxiety, depression and life quality questionnaire between before andafter treatment. As a result, the muscle strenght of patients treated with statins should be evaluated regularly although they had no muscle complain, elevated creatine kinaselevels and also risk factor. So patients who received statin therapy should be concluded by physiatrists before starting and continued treatment for at least three months following periods.
Açıklama
YÖK Tez No: 306229
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation, Anksiyete, Anxiety, Antikolesteremik ajanlar, Anticholesteremic agents, ESWL, ESWL, Eklemler, Joints, Hiyaluronik asit, Hyaluronic acid, Kıkırdak, Cartilage, Osteokondrodisplaziler, Osteochondrodysplasias, Sıçanlar, Rats, Yaşam kalitesi, Quality of life, Ölçekler, Scales
