早期阿托伐他汀联合依折麦布治疗急性冠脉综合征临床观察

Effect of atorvastatin,alone and in combination with ezetimibe in the treatment of patients with acute coronary syndrome

目的:评价早期阿托伐他汀联合依折麦布治疗急性冠脉综合征(ACS)的疗效及安全性。方法:79例ACS患者随机分为联合治疗组(阿托伐他汀20 mg/d和依折麦布10 mg/d,n=41)和阿托伐他汀组(阿托伐他汀20 mg/d,n=38)。治疗2周后检测患者血脂、丙氨酸转氨酶(ALT)、磷酸肌酸激酶(CK)水平,并观察两组治疗2周内心血管事件及相关不良反应的发生率。结果:经治疗2周后,两组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)低于治疗前,联合治疗组胆固醇水平下降较阿托伐他汀组更明显(P<0.05)。联合治疗组心血管事件(再发心绞痛、急性心肌梗死)发生率低于阿托伐他汀组(P<0.05)。结论:早期应用阿托伐他汀联合依折麦布治疗急性冠脉综合征较单用阿托伐他汀能更显著降低胆固醇水平,减少心血管事件,具有良好的安全性。

Objective： To evaluate the efficacy and security of atorvastatin combination with ezetimibe in patients with acute coronary syndrome（ACS）. Methods： A total of 79 patients with ACS were random- ized to receive atorvastatin （20 mg/d） and ezetimibe （10 mg/d, combination group, n =41 ） or atorvasta- tin （20 mg/d） alone （ atorvastatin group, n = 38）. Levels of lipids of two groups were detected as well as ALT and CK after two weeks therapy. The cardiovascular events and related side-effects were observed dur- ing two weeks of the treatment. Results： Compared to baseline, the levels of total cholesterol, triglyceride and low density lipoprotein-cholesterol were reduced after two weeks in two groups. The levels of cholesterol in combination group were significantly reduced than those in atorvastatin group （ P 〈 0.05 ）. The incidence of cardiovascular events （recurrence of angina pectoris and acute myocardial infarction ） in combination group was lower than that in atorvastatin group （P 〈 0.05 ）. Conclusion： The combined atorvastatin and ezetimibe therapy early after ACS had good security, and was superior to atorvastatin alone on reducing the levels of cholesterol and the incidence of cardiovascular events.