瑞舒伐他汀联合依折麦布治疗冠心病伴早期糖尿病肾病疗效观察

Therapeutic effects of rosuvastatin combined with ezetimibe on coronary heart disease complicated by early diabetic nephropathy

目的本研究通过瑞舒伐他汀联合依折麦布治疗冠心病伴早期糖尿病肾病,以寻找冠心病伴早期糖尿病肾病更好的治疗方法,预防急性心血管事件及终末期肾病的发生。方法选择2013年7月至2014年1月河北省老年病医院明确诊断为血糖控制良好的稳定型心绞痛合并早期糖尿病肾病患者80例。男42例,女38例;年龄60岁以上,相互之间无血缘关系。随机分为治疗组和对照组,每组40例。对照组在常规治疗基础上加服瑞舒伐他汀10 mg/d。治疗组在常规治疗基础上加服瑞舒伐他汀10 mg/d和依折麦布10 mg/d。结果治疗12周后LDL在治疗组较对照组下降更明显(P<0.01)。对照组心绞痛发作时间较治疗前明显缩短,心绞痛发作次数较治疗前明显减轻(P<0.05)。治疗12周时,心绞痛发作次数在治疗组降低更加明显,2组差异有统计学意义(P<0.05);治疗组和对照组UAER水平较治疗前均有显著下降(P<0.01),治疗组UAER较对照组下降更为显著,差异有统计学意义(P<0.05);2组治疗前后肌酐、肌酸激酶、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶变化差异无统计学意义(P>0.05)。结论联合应用瑞舒伐他汀和依折麦布治疗冠心病伴早期糖尿病肾病,可以明显减少心绞痛的发作次数和持续时间,促进心肌缺血改善的同时减少尿微量蛋白尿,可以更有效的降低LDL及TC、提高血脂高达标率,没有增加不良反应事件,体现了良好的安全性。

Objective To observe the therapeutic effects of rosuvastatin combined with ezetimibe on coronary heart disease complicated by early diabetic nephropathy in order to look for more effective therapy to prevent the pathogenesis of acute cardiovascular events and end-stage nephropathy.Methods Eighty patients with stable angina pectoris complicated by early diabetic nephropathy diagnosed in Hebei Province Geriatric Hospital from July 2013 to January 2014 were enrolled in the study,including 42 male patients and 38 female patients,whose age was over 60 years and whose blood sugar was controlled effectively,without blood relationship each other.There patients were randomly divided into observation group and control group,with 40 patients in each group.On the basis of routine therapy,the patients in control group were treated by rosuvastatin10 mg / d,however,the patients in observation group,on the basis of routine therapy,were treated by rosuvastatin 10 mg / d ＋ezetimibe 10 mg / d.Results After 12-week treatment,the levels of LDL in observation group were significantly decreased,as compared with those in control group（ P〈0.01）.The angina pectoris attacks time in control group was obviously shortened,and the attacks frequency of angina pectoris was obviously decreased,as compared with that before treatment（ P〈0.05）.After 12-week treatment,the attacks frequency of angina pectoris in observation group was significantly decreased,as compared with that in control group（ P〈0.05）.After 12-week treatment,the UAFR levels in both groups were significantly decreased,as compared with those before treatment（ P〈0.01）,moreover,the decrease degree in observation group was more obvious than that in control group（ P〈0.05）.Howevrer there were no significant differences in the levels of serum creatinine,serum creatine kinase,alanine aminotransferase,aspartate aminotransferase before and after treatment between two groups（ P〉0.05）.Conclusion In the treatment of coronary heart disease complicated by early diabetic nephropathy,the combined application of rosuvastatin with ezetimibe can significantly reduce the frequency and duration of angina pectoris attacks,and can promote the improvement of myocardial ischemia,at the same time,can decrease microalbuminuria and reduce more effectively the levels of LDL and TC,without increasing the incidence of adverse events,with better safety.