山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (11): 46-49.doi: 10.6040/j.issn.1671-7554.0.2015.531
容春莉, 姚文静, 杨倩, 李如意, 曹东平, 刘美霞, 彭应心
RONG Chunli, YAO Wenjing, YANG Qian, LI Ruyi, CAO Dongping, LIU Meixia, PENG Yingxin
摘要: 目的 探讨阿托伐他汀钙联合依折麦布治疗冠状动脉粥样硬化并高脂血症患者的临床疗效与安全性.方法 选取2013年5月至2014年2月收治的冠状动脉粥样硬化并高脂血症患者82例,根据就诊顺序随机分为单用组和联用组,每组41例.单用组采用阿托伐他汀钙治疗,20 mg/次,1次/d.联用组在此基础上加用依折麦布,10 mg/次,1次/d.比较两组治疗12周后降脂效果差异.结果 治疗前单用组与联用组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)值无明显差异(P>0.05),治疗后两组TC、TG、LDL-C、CRP值较治疗前均显著降低,HDL-C显著增高(P<0.05),联用组较单用组变化更加显著(P<0.05).联用组LDL-C达标率(78.05%)显著高于单用组(53.66%)(P<0.05).两组治疗前后肝功能、肾功能指标变化差异无统计学意义(P>0.05).结论 阿托伐他汀钙联合依折麦布治疗冠状动脉粥样硬化并高脂血症的降脂效果更显著,同时不会加重肝肾负担.
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[1] Kaptoge S, Di Angelantonio E, Lowe G, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis[J]. Lancet, 2010, 375(9709): 132-140. [2] Cleeman JI. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adults treatment panel III)[J]. JAMA, 2001, 285(19): 2486-2497. [3] 中国成人血脂异常防治指南制定联合委员会. 中国成人血脂异常防治指南[J]. 中华心血管病杂志, 2007, 35(5): 390-419. Joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults[J]. Chinese Journal of Cardiology, 2007, 35(5):390-419. [4] Tikkanen MJ, Fayyad R, Faergeman O, et al. Effect of intensive lipid lowering with atorvascular outcomes in coronary heart disease patients with baseline elevations in alanine aminotransferase levels[J]. Eur Heart J, 2013, 34(1): 679-683. [5] 李毅亭, 龙明智. 强化他汀治疗对急性冠脉综合征患者炎症因子和预后的影响[J]. 南京医科大学学报: 自然科学版, 2009, 10: 1423-1426. LI Yiting, LONG Mingzhi. Effects of intensive statin therapy on inflammatory factors and prognosis in patients with acute coronary syndrome[J]. Acta Universitatis Medicinalis Nanjing:Natural Science, 2009, 10: 1423-1426. [6] Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes[J]. N Engl J Med, 2004, 350(15): 1495-1504. [7] 王艳丽, 于晓原, 张璐璐, 等. 阿托伐他汀钙治疗老年冠心病合并高脂血症的疗效观察[J]. 西北药学杂志, 2013, 1(6) :630-631. WANG Yanli, YU Xiaoyuan, ZHANG Lulu, et al. Clinical effect of atorvastatin calcium in the treatment of elder patients with coronary heart disease complicated with hyperlipidemia[J]. Northwest Pharmaceutical Journal, 2013, 1(6): 630-631. [8] Mega JL, Braunwald E, Wiviott SD, et al. Rivaroxaban in patients with a recent acute coronary syndrome[J]. N Engl J Med, 2012, 366(1): 9-19. [9] 陈莉, 王勇. 稳定型冠心病患者的强化他汀治疗[J]. 中国全科医学, 2012, 15(14): 1557-1559. CHEN Li, WANG Yong. Intensive statin therapy in patients with stable coronary artery disease[J]. Chinese General Practice, 2012, 15(14): 1557-1559. [10] 王一楠. 阿托伐他汀联合非诺贝特治疗老年混合型高脂血症临床疗效观察[J]. 中国心血管病研究, 2011, 9(10): 765-768. [11] Bays HE, Neff D, Tomassini JE, et al. Ezetimibe: cholesterol lowing and beyond[J]. Expert Rev Cardiovasc Ther, 2008, 6(4): 447-470. [12] 张茗, 任祝军, 赵丽芬,等. 依折麦布联合小剂量普伐他汀治疗高胆固醇血症疗效观察[J]. 河北医药, 2013, 35(15): 2301-2302. [13] 童程程, 唐海沁, 李瑾. 依折麦布联合辛伐他汀降脂疗效和安全性的Meta分析[J]. 中国循证心血管医学杂志, 2013, 5(2): 116-120. TONG Chengcheng, TANG Haiqin, LI Jin. A Meta-analysis on lipid-lowering effect and safety of ezetimibe combining simvatatin therapy[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2013, 5(2): 116-120. [14] Dujovne CA, Ettinger MP, McNeer JF, et al. Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia[J]. Am J Cardiol, 2002, 90(10): 1092-1097. [15] 毕磊, 曹丹阳, 王伟, 等. 依折麦布联合辛伐他汀在冠心病高脂血症患者中降脂疗效及安全性观察[J]. 中国循证心血管医学杂志, 2014, 6(4): 422-423. BI Lei, CAO Danyang, WANG Wei, et al. Lipid-lowering efficacy and safety of ezetimibe combining simvastatin in patients with coronary heart disease and hyperlipidemia[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2014, 6(4): 422-423. |
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