急性冠状动脉综合征合并糖尿病患者阿托伐他汀联合苯扎贝特治疗的不良心血管事件分析

The effects of combination therapy with atorvastatin and bezafibrate on outcomes of patients with diabetes mellitus and acute coronary syndrome

目的评估阿托伐他汀联合苯扎贝特对急性冠状动脉综合征（ACS）合并糖尿病患者近期和远期预后的影响。方法 ACS合并糖尿病住院患者480例，均接受阿托伐他汀治疗，其中162例联合苯扎贝特治疗（观察组），318例为对照组。记录出院后30d主要不良心血管事件、再住院率和1年死亡率。结果30d主要不良心血管事件发生率、再住院率和1年死亡率观察组分别为8%、13.0%和3.7%，显著低于对照组的15.7%、22.6%和8.8%（均P＜0.05）。多因素分析显示阿托伐他汀联合苯扎贝特治疗能减少ACS后30d主要不良心血管事件的风险（OR=0.57，95%CI0.35~0.93）。结论阿托伐他汀联合苯扎贝特治疗有助于改善糖尿病患者ACS后的近期及远期预后。

Objective To evaluate the impact of combined therapy with bezafibrate and atorvastatin on short- and long- term outcomes of patients with both acute coronary syndromes （ACS） and diabetes mel itus （DM）. Methods 480 patients with ACS and DM were enrol ed. Of them, 162 cases were treated with atorvastatin and bezafibrate （observation group） and 318 cases were treated with atorvastatin （control group）. 30- day major adverse cardiovascular events （MACEs）, 30- day re- hospitalization rate and 1- year mortality were recorded. Results The 30- day MACEs, 30- day rehospitalization rate and 1- year mortality were 8%, 13.0% and 3.7%, respectively, in observation group, significantly lower than 15.7%, 22.6%and 8.8%in control group（ al P〈0.05）. Multivariate analysis showed that combined therapy with atorvastatin and bezafibrate reduced the risk of 30- day MACEs after ACS （OR=0.57 , 95% CI 0.35~0.93）. Conclusion Combination therapy with atorvastatin and bezafibrate may contribute to improve short- and long- term outcomes of DM patients after ACS.