依折麦布对冠心病伴肝酶升高患者的疗效与安全性

Curative effect and safety of ezetimibe for coronary heart disease patients complicated with elevated liver enzyme

目的探讨依折麦布对冠心病伴肝酶升高患者的疗效与安全性。方法 84例他汀引起肝酶升高3倍以上冠心病患者,随机分为A组与B组,每组42例,A组停用他汀;B组给予依折麦布治疗。疗程4周,治疗前后测定总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)、丙氨酸转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)水平;随访主要不良心血管事件(MACEs)。结果与治疗前比较,治疗后A组TC、LDL-C、TG均升高,HDL-C下降(P<0.05);治疗后B组TC、LDL-C、TG均下降,HDL-C升高(P<0.05)。治疗后B组TC、LDL-C、TG低于A组,HDL-C高于A组(P<0.05)。治疗后两组ALT、AST均较治疗前显著下降(P<0.01),组间比较差异无统计学意义(P>0.05)。A、B组MACEs发生率分别为9.5%、2.4%,差异具有统计学意义(P<0.05)。结论他汀致肝酶升高冠心病患者,换用依折麦布治疗安全有效。

Objective To investigate curative effect and safety of ezetimibe for coronary heart disease patients complicated with elevated liver enzyme. Methods A total of 84 coronary heart disease patients complicated with elevated liver enzyme over 3 times were randomly divided into group A and group B, with 42 cases in each group. The group A stopped receiving statin, and the group B received ezetimibe for treatment. Their treatment lasted for 4 weeks. Detection was made on levels of total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterin（LDL-C）, high density lipoprotein cholesterol（HDL-C）, alanine aminotransferase（ALT）, and aspartate aminotransferase（AST）. Follow-up was taken for major adverse cardiovascular events（MACEs）. Results Comparing with those before treatment, the group A had higher TC, LDL-C, TG and lower HDL-C after treatment（P〈0.05）, while the group B had lower TC, LDL-C, TG and higher HDL-C（P〈0.05）. After treatment, the group B had lower TC, LDL-C and TG than group A, and its HDL-C was higher than that in group A（P〈0.05）. Both groups had remarkably decreased ALT and AST after treatment（P〈0.01）, and their difference had no statistical significance between them（P〉0.05）. Incidence of MACEs was 9.5% and 2.4% respectively in the group A and the group B, and their difference had statistical significance（P〈0.05）. Conclusion Alternative application of ezetimibe is safe and effective for coronary heart disease patients with elevated liver enzyme induced by statin.