依折麦布联合氟伐他汀对冠心病高危患者的强化调脂作用

Ezetimibe Combined with Fluvastatin on Intensive Lipid- Lowering in High Risk Patients with Coronary Heart Disease

目的观察依折麦布联合氟伐他汀对冠心病高危患者的强化调脂作用。方法选择医院2014年收治的冠心病高危患者74例,随机分为观察组与对照组,各37例。两组均给予常规治疗,对照组加用2倍剂量(40 mg/d)的氟伐他汀,观察组加用1倍剂量(20 mg/d)的氟伐他汀和依折麦布(10 mg/d),两组患者均治疗3个月。比较两组患者的临床疗效,检测超敏C反应蛋白(hs-CRP)浓度、血脂总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平,计算颈动脉斑块Crouse积分,记录不良反应的发生情况。结果治疗后,观察组总有效率为75.68%,与对照组的67.57%相当(P>0.05);两组患者TC,LDL-C水平均较治疗前下降(P<0.05),HDL-C水平升高(P<0.05),且观察组改善程度显著优于对照组(P<0.05);两组患者hs-CRP表达水平均降低,且观察组改善幅度显著优于对照组(P<0.05);两组患者Crouse积分均下降,且观察组下降的幅度显著大于对照组(P<0.05)。观察组总不良反应发生率为10.81%,显著低于对照组的21.62%(P<0.05)。结论依折麦布联合氟伐他汀能调节冠心病患者的血脂代谢,可在一定程度上延缓动脉硬化进程,耐受性较好,值得临床推广。

Objective To observe Ezetimibe combined fluvastatintin intensive lipid in patients with coronary heart disease risk. Methods 74 cases of patients with high risk of coronary heart disease were randomly divided into observation group and control group, 37 cases in each group. The two groups were given the basis of foundation treatment, the control group was added with 2 times dosage of fluvas- tatin （40 mg/d）,and the treatment group was added with fluvastatin （20 mg/d） and ezetimibe（10 mg/d）. The two groups were treat- ment for 3 months. The clinical efficacy of the two groups were compared,the hs-CRP concentration in blood,total cholesterol （TC）,triglyceride （TG）,high-density lipoprotein cholesterol （HDL- C） and low density lipoprotein cholesterol （LDL- C） levels were detect- ed,the Crouse score of carotid plaques was caculated,and the adverse reactions related to the drug were recorded. Results After treat- ment,the total effective rate of the observation group was 75.68% ,which had no statistically significant difference with 67.57% of the control group （P 〉 0. 05）;the levels of TC,LDL- C and hs- CRP levels decreased in the two groups （P 〈 0. 05）,HDL- C expres- sion levels increased （P 〈 0. 05）,and the range of improvement in the observation groups was better than the control group （P 〈 0.05）; the Crouse scores of the two groups showed statistically significant difference compared with before treatment, and the decrease in the observation groups was more than the control group （P 〈 0. 05）;the occurrence rate of adverse reaction in the observation group was 10. 81% ,which was obviously lower than 21.62% of the control group （P 〈 0. 05）. Conclusion Ezetimibe combined with fluvastat- intins can adjust blood lipid metabolism in patients with coronary heart disease,can slow hardening of the arteries process to a certain extent, at the same time has no serious adverse reaction ,is safer and worthy of clinical promotion.