辛伐他汀和非诺贝特对高脂血症患者血脂水平的影响

Comparative analysis on influence of simvastatin and fenofibrate on serum level of blood fat in patients with hyperlipidemia

目的观察辛伐他汀和非诺贝特治疗高脂血症的临床疗效,对比分析二者对血清血脂水平的影响。方法将150例混合型高脂血症患者随机分为他汀组、贝特组、联合组三组,每组各50例,他汀组予以辛伐他汀10 mg/d治疗,贝特组予以非诺贝特200 mg/d治疗,联合组予以辛伐他汀10 mg/d和非诺贝特200 mg/d联合治疗,监测治疗前、治疗后12周的总胆固醇(TC)、低密度脂蛋白(LDL-C)、三酰甘油(TG)及高密度脂蛋白(HDL-C)的变化,同时监测谷丙转氨酶(ALT)、血尿素氮(BUN)、血肌酐(Cr)及肌酸激酶(CK)的变化。结果治疗12周后,三组TC、LDL-C、TG及HDL-C的变化均有所改善,差异具有统计学意义(P<0.05)。他汀组(TC:4.21±0.62 mmol/L,LDL-C:3.21±0.61mmol/L)与贝特组(TC:4.91±0.53 mmol/L,LDL-C:3.52±0.52 mmol/L)比较,差异有统计学意义(P<0.05),他汀组与联合组(TC:4.31±0.63 mmol/L,LDL-C:3.22±0.61 mmol/L)比较,差异无统计学意义(P>0.05)。贝特组与联合组比较,差异有统计学意义(P<0.05)。他汀组(HDL-C:1.21±0.22 mmol/L,TG:2.91±0.62 mmol/L)与贝特组(HDL-C:1.32±0.11mmol/L,TG:1.52±0.51 mmol/L)比较,差异无统计学意义(P>0.05),他汀组与联合组(HDL-C:1.41±0.21 mmol/L,TG:1.21±0.62mmol/L)比较,差异有统计学意义(P<0.05)贝特组与联合组比较,差异有统计学意义(P>0.05)。三组不良反应比较,差异无显著性(P>0.05)。结论联合应用辛伐他汀与非诺贝特对混合型高脂血症患者的总有效率要优于单独使用辛伐他汀或非诺贝特,且不良反应没有增高,具有良好的安全性。

Objective To observe the clinical efficacy of simvastatin and fenofibrate on hyperlipidemia, and compare and analyze their influence on serum level of blood fat. Methods The patients with mixed hyperlipidemia（n=150） were randomly divided into simvastatin group, fenofibrate group and combining group（each n=50）. The simvastatin group was given simvastatin（10 mg/d）, fenofibrate group, fenofibrate（200 mg/d） and combining group, simvastatin（10 mg/d） and fenofibrate（200 mg/d）. The changes of total cholesterol（TC）, low-density lipoprotein（LDL-C）, triglycerides（TG） and high-density lipoprotein（HDL-C） were detected 12 w before treatment and after treatment for 12 w, at the same time the changes of alanine aminotransferase（ALT）, blood urea nitrogen（BUN）, serum creatinine（Cr） and creatine kinase（CK） were monitored. Results After treatment for 12 w, TC, LDL-C, TG and HDL-C were ameliorated in 3 groups（P〈0.05）. The comparison between simvastatin group（TC： 4.21±0.62 mmol/L, LDL-C： 3.21±0.61 mmol/L） and fenofibrate group（TC： 4.91±0.53 mmol/L, LDL-C： 3.52±0.52 mmol/L） showed statistical difference（P〈0.05）. The comparison between simvastatin group and combining group（TC： 4.31±0.63 mmol/L, LDL-C： 3.22±0.61 mmol/L） showed no statistical difference（P〈0.05）, and comparison between fenofibrate group and combining group showed statistical difference（P〈0.05）. The comparison between simvastatin group（HDL-C： 1.21±0.22 mmol/L, TG： 2.91±0.62 mmol/L） and fenofibrate group（HDL-C; 1.32±0.11mmol/L, TG： 1.52±0.51 mmol/L） showed no statistical difference（P〈0.05）. The comparison between simvastatin group and combining group（HDL-C： 1.41±0.21 mmol/L, TG： 1.21±0.62 mmol/L） showed statistical difference（P〈0.05） and comparison between fenofibrate group and combining group showed statistical difference（P〈0.05）. The difference in adverse reactions had no statistical significance among 3 groups（P〈0.05）. Conclusion The combined medication of simvastatin and fenofibrate has higher total effective rate than singly simvastatin or single fenofibrate in patients with mixed hyperlipidemia with higher safety, and adverse reactions is not increased.