代谢综合征患者辛伐他汀联合依折麦布降血脂治疗的评价

Evaluation of simvastatin combined with ezetimibe on therapy of lowing blood lipids in metabolic syndrome patients

目的通过辛伐他汀联合依折麦布对代谢综合征患者降血脂的对照研究，观察其调脂疗效、不良反应及心脑血管事件发生率。方法将120例代谢综合征的患者分成两组。实验组60例，予以常规剂量辛伐他汀20mg治疗基础上加用依折麦布10mg治疗；对照组60例，予以常规辛伐他汀20mg治疗，两者疗程均为4年。观察两组降脂的疗效，副作用及心脑血管事件发生情况，并进行对比研究。结果两组均能有效降低血脂，且治疗后实验组与对照组比较总胆固醇（TC）[（3．05±1．17）mmol／L与（4．94±1．13）mmol／L]、低密度脂蛋白胆固醇（LDL-C）[（2．12±1．03）与（3．16±1．11）mmol／L]、甘油三酯（TG）[（1．02±0．29）mmol／L与（1．65±0．32）mmol／L]，差异均有统计学意义（P均〈0．05）。心血管事件实验组共发生3例，对照组10例；脑血管事件实验组发生5例，对照组13例。实验组心、脑血管事件发生均低于对照组（X2值分别为4．08、4．37，P均〈0．05）。结论辛伐他汀和依折麦布的联合治疗更显著降低代谢综合征患者血脂并减少心脑血管事件发生且不良反应无明显增加。

Objective To investigate the efficacy, adverse effect and the incidence of cardiovascular and cerebrovascular events by comparative study on simvastatin combined with ezetimibe on therapy of lowing blood lipids in metabolic syndrome patients. Methods One hundred and twenty metabolic syndrome patients were divided into experiment group （ n=60） and control group （ n = 60）. The experiment group was treated with 20 mg of simvastatin associated 10 mg of ezetimibe daily. The control group was treated with conventional-dose 20 mg of simvastatin. The period of treatment was 4 years in both groups. The efficacy, adverse effect and the occurrence of cardiovascular and cerebrovascular events were observed and analyzed. Results Blood lipid were significantly decreased in both groups after the treatment~ There was significant difference on total Cholesterol （TC） [ （3.05±1.17）mmol/L vs （4.94±1.13 ）retool/L, P 〈 0. 05 ], low density lipoprotein cholesterol （ LDL- C） [ （2. 12±1.03 ） mmol/L vs （3.16±1.11 ） mmol/L, P 〈 0. 05 ] and triglyceride （TC） （ 1.02±0. 29） mmol/L vs （1.65±0.32）mmol/L,P 〈0. 05） between experiment group and control group. There were 3 cases of cardiovascular events in experiment group and 10 cases in control group, 5 cases of cerebrovascular events in experiment group and 13 cases in control group. The incidence of cardiovascular and cerebrovascular in experimnt group was significantly lower than that in control group （X2 = 4. 08 and 4. 37, respectively,P 〈 0. 05 ） Conclusion Combination therapy with simvastatin and ezetimibe is more effective and it can significantly decrease the incidence of cardiovascular and cerebrovascular events in metabolic syndrome oatients.