阿托伐他汀联合非诺贝特治疗合并甘油三酯升高的ACS患者的疗效观察

Clinical study of atorvastatin plus fenofibrate treatment on ACS patients with high triglyceride

目的观察阿托伐他汀联合非诺贝特治疗合并甘油三酯升高的ACS患者的临床疗效与安全性。方法将400例合并甘油三酯升高的ACS患者随机分为两组,每组200例,联合降脂组采用20 mg/d阿托伐他汀联合250 mg/d非诺贝特治疗;他汀降脂组单用20 mg/d阿托伐他汀治疗。检测两组给药前后血脂指标、高敏CRP(hs-CRP),观察生命体征等。结果治疗后两组患者总胆固醇、甘油三酯、LDL-C、HDL-C、非HDL-C、载脂蛋白AⅠ、载脂蛋白B、hs-CRP等指标较治疗前均明显改善,并且联合降脂组患者治疗效果明显优于他汀降脂组,差异有统计学意义(P<0.05)。他汀降脂组的临床终点事件发生率为8%,明显高于联合降脂组的4%(P<0.05)。仅10例(他汀降脂组4例,联合治疗组6例)出现ALT,AST或CK一过性轻度升高(正常值上限的1倍),4周后再次复查均恢复正常。结论阿托伐他汀与非诺贝特联合治疗合并甘油三酯升高的ACS患者疗效显著,不良反应少,值得临床推广应用。

Objective To investigate the curative effect and safety of atorvastatin plus fenofibrate treatment on acute coronary syndrome （ACS）patients with high triglyceride （TG）. Methods Four hundreds ACS patients with high TG were randomly divided into two groups （200 cases in each group）. Atorvastatin 20 mg/d combined with fenofibrate 200 mg/d were used in the combination group while only atorvastatin 20 mg/d was used in the control group. Lipid Levels were detected in two groups before and after treatment and vital signs were also observed. Results Levels of total cholesterol （TC）,TG,LDL-C,HDL-C,apoAI,apoB, non-HDL-C and hs-CRP were greatly improved after treatment in both two groups,and compared to control group,the combination group got better results （P＆lt;0.05 ）. Besides,there is also a significant difference be-tween both two groups in terms of the incidence of clinical endpoints [4% vs 8% （control group）,P＆lt;0.05 ]. Transient mild elevation of ALT,AST,or CK （1 times ULN）only occurred in 1 0 cases （control group four cases,the combination group six cases）,which became normal four weeks later. Conclusions Combi-nation of atorvastatin and fenofibrate in treatment of ACS patients with high TG has a better clinical outcome with fewer side effects and is worthy of clinical application.