時尚雙語:“司他汀”正在擾亂您的記憶嗎？

I've heard that taking statin drugs to lower cholesterol can cause memory loss? Is there any truth to this?

I've read anecdotal reports associating statins with memory loss, and I'm aware of an ongoing study at the University of California, San Diego (UCSD), that is investigating the effects of these drugs on thinking, mood, behavior, and quality of life. The same researchers have also been collecting reports about other side effects that patients attribute to statins, including peripheral neuropathy (tingling and numbness or burning pain), headaches, joint pains, and abdominal pain, problems with sleep and with sexual function, fatigue, dizziness, a sense of detachment, swelling, shortness of breath, changes in vision, temperature regulation, blood sugar, blood pressure, weight, as well as hunger, breast enlargement, dry skin, rashes, nausea, upset stomach, bleeding, and ringing in ears or other noises. Based on some 5,000 reports accumulated by early 2008, memory problems were the second most common side effect reported. (Muscle aches were first.) Memory returned to normal when affected patients discontinued the statins.

Statins are known to cause muscle aches and liver dysfunction; warnings of both possibilities are prominent in the printed instructions patients get when they pick up their prescriptions. So far, no causal link between the drugs and memory loss has been demonstrated. Worldwide, some 25 million people take these cholesterol-lowering agents. With that denominator, even a few thousand reports of memory loss represent only a tiny fraction of patients.

How statins might affect memory isn't known. But since there's lots of cholesterol in the brain, lowering levels throughout the body could impact brain function.

In general, I wouldn't worry about the effect of statins on memory. But if you're taking the drug and find that you're becoming forgetful, tell your doctor. Lowering your dose may help. Or your physician might suggest going off the drug for a few weeks to see if your memory improves. If it does, you should discuss with your physician other approaches to cholesterol control.

Remember, it is possible to lower cholesterol without medication: get at least 30 minutes a day of aerobic exercise and reduce the amount of saturated fat and trans-fats in your diet. Other beneficial measures include drinking green tea, eating one clove of garlic per day (diced or crushed in food), and consuming more soluble fiber (such as oat bran), foods rich in omega-3 fatty acids (good sources include salmon, sardines and walnuts) and plenty of leafy greens and fresh fruits.

If lifestyle changes don't help, you could try red rice yeast (Monascus purpureus), a source of naturally occurring statins, before resorting to pharmaceutical versions. Because it delivers a mix of those compounds rather than a single molecule, red rice yeast is less likely to cause side effects.

Andrew Weil, M.D.

我已聽說服用司他汀藥物降低膽固醇會引起記憶力喪失。這是否具有真實性呢？

我已讀過司他汀與記憶力喪失相關的軼事，而且我知道在美國加州大學聖地亞哥分校（加州大學聖地亞哥分校）的一項持續的研究，換句話說就是調查這些藥物對思想，情緒，行爲，和基本的生活條件的影響。同時，研究人員們還一直在收集關於其他副作用的報告，患者把這些副作用都歸因於司他汀，包括周圍神經病變（刺痛和麻木或灼痛），頭痛，關節痛，腹痛，睡眠和性功能問題，疲勞，暈眩，意識渙散，腫脹，呼吸短促，在視野，體溫調節，血糖，血壓，體重方面的變化無常，以及飢餓，乳腺癌的擴大，皮膚乾燥，皮疹，噁心，肚子痛，大量出血，和耳鳴或其他的噪音。據2008年年初所收集的大約5000份報告顯示，記憶力問題是所報導的第二個最常見的副作用。 （肌肉疼痛位居第一。 ）當受影響的患者停止了服用司他汀，記憶體恢復正常。

衆所周知，司他汀會造成肌肉疼痛和肝功能異常;當患者拿到自己的藥方時，在印刷的用法說明書上這兩種可能性的警告顯而易見。到目前爲止，這些藥物和記憶力喪失之間沒有因果關係得已證明。世界各地大約2500萬人服用了膽固醇降低作用劑。相對於那分母而言，即使幾千份有關記憶力喪失的報道也僅代表了一極小部分的患者。

司他汀如何可能影響記憶就不爲人知。但是由於有大量的膽固醇在大腦中，降低整個身體的膽固醇量是可能影響腦功能的。

總的來說，我不會擔心司他汀對記憶力的影響。但如果您正在服藥，並發現您正變得健忘的話，請告訴您的醫生。降低您的劑量可能有益。或者您的醫生可能建議停用藥物幾個星期，看看您的記憶力是否有所改善。若確實如此，您應該與您的醫生討論其他控制膽固醇方法。

請記住，無藥物降低膽固醇是有可能的：每天至少30分鐘有氧運動且在您的飲食中減少飽和脂肪和反型脂肪的攝入量。其他有益的措施，包括每天喝綠茶，吃大蒜（切成丁或粉碎在食物中） ，以及攝取更多的可溶性纖維（如燕麥麩）和富含歐米加- 3脂肪酸的食物（良好的來源包括鮭魚，沙丁魚和胡桃）以及大量的綠葉菜類和新鮮水果。

如果生活方式的改變不起作用，您可以嘗試紅米酵母（紅紫色） ，來源於天然的司他汀，在訴諸製藥版本之前。因爲它提出了那些化合物的組合，而不是單一的分子，紅米酵母是不太可能產生副作用的。