不稳定型心绞痛患者联合降脂治疗对患者的影响

Effectiveness of Atorvastatin Co-administration with Ezetimibe in Patients with Unstable Angina

目的通过分析不稳定型心绞痛患者单用阿托伐他汀或者依折麦布联合阿托伐他汀治疗对总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、前列环素(PGI2)、血栓素A2(TXA2)及C反应蛋白(CRP)的影响,了解依折麦布联合阿托伐他汀治疗对调脂、保护血管内皮功能及减轻炎性反应的效果。方法随机选择2012年6月—2014年6月186例不稳定型心绞痛患者进行单用阿托伐他汀治疗(每晚口服阿托伐他汀20 mg)和联合药物治疗(每晚口服阿托伐他汀20 mg和依折麦布10 mg)。观察服药前及服药12周后的TC、TG、LDLC、HDLC、PGI2、TXA2及CRP的水平变化。结果两组治疗前TC、TG、LDLC、HDLC、PGI2、TXA2及CRP的水平元明显差别。治疗12周后与治疗前比较,TC、TG、LDLC、TXA2明显降低,HDLC及PGI2明显升高;而联合治疗较单用阿托伐他汀治疗的TC、TG、LDLC、TXA2降低更明显HDLC及PGI2升高更明显,差异有统计学意义,两组患者均未出现严重毒副作用。结论 依折麦布联合阿托伐他汀治疗能够更加有效的发挥调脂、保护血管内皮功能及减轻炎性反应的作用,安全可靠。

[Abxtact] Objective The effect of atorvastatin and atorvastatin co-administration with ezetimibe on total cholesterol （TC） ,triglyc-erin（TG）, low density lipoprotein cholesterol （ LDLC）,high density lipoprotein cholesterol （HDLC）,prostacyclin （ PGI2） and throm-boxane a 2 （ TXA2） and c reactive protein （CRP） in patients with unstable angina were compared to evaluate the advantage and disadvantage. Methods 186 patients with unstable angina enrolled from June 2012 to June 2014 were divided into atorvastatin group （ 20 mg qn） and co-administration group（atorvastatin 20 mg qn and ezetimibe 10 mg qn） randomly ; TC,LDLC,PGI2,TXA2 and CRP were measured at admission and 12 weeks after treatment. Results There was no significant difference in TC,TG, LDLC, HDLC, PGI2,TXA2 and CRP levels between. After 12 weeks, the level of TC ,TG,LDLC ,TXA2 and CRP in two groups were lower than pre-treatment,and the level of HDLC and PGI2 were higher. However,the level of TC,TG,LDLC ,TXA2 and CRP were more lower and the level of HDLC and PGI2 were more higher 12 weeks after treatment in co-administration group than atorvastatin group.There was no serious side effect in both groups. Conclusion Atorvastatin combining ezetimibe was more effect on modifying lipid ,vascular endothelial function and lowering inflammatory reaction than atorvastatin alone in unstable angina patients .