依折麦布联合阿托伐他汀对不稳定型心绞痛患者血清甘油三酯的影响

Lipid-lowering efficacy of Atorvastatin and Ezetimibe combination therapy for patients with unstable angina

目的观察依折麦布联合阿托伐他汀对血清甘油三酯(TG)的影响。方法选择2013年1月至12月在大连医科大学附属第一医院心内科住院,诊断为不稳定型心绞痛且行冠状动脉支架植入术并伴有低密度脂蛋白胆固醇(LDL-C)≥120 mg/d L、TG≥150 mg/d L的患者99例。随机分为两组,对照组52例,给予阿托伐他汀20 mg/d睡前口服;试验组47例,给予阿托伐他汀20 mg/d+依折麦布10 mg/d睡前口服。对两组患者治疗前及治疗4周后TG水平进行对比分析。结果对照组治疗后TG为(190.25±79.26)mg/d L,与治疗前(228.48±70.10)mg/d L比较,差异有显著性意义(P<0.01)。试验组治疗后TG为(153.34±52.41)mg/d L,与治疗前(255.89±100.03)mg/d L比较,差异有显著性意义(P<0.01)。治疗4周后试验组与对照组比较,TC、TG、HDL和LDL-C差异均有显著性意义(P<0.05);TC、TG和LDL-C水平均明显下降,且下降幅度显著大于对照组(P<0.05)。两组患者治疗前后肝功能、肾功能、肌酸激酶(CK)无明显变化。结论对于不稳定型心绞痛患者,阿托伐他汀联合依折麦布能明显降低TG水平,临床应用安全,患者耐受性良好。

Objective To compare the efficacy and safety of statin alone and the combination of statins and ezetimibe in reducing TG levels. Methods Ninety-nine patients with LDL-C≥120 mg/dL, TG≥150 mg/dL and unstable angina （UA） diagnosed in the First Affiliated Hospital of Dalian Medical University between January 2013 and December 2013, were recruited. They were all treated with percutaneous coronary intervention. They were randomly divided into two groups, including 52 patients in the control group who were given atorvastatin 20 mg/d orally per night and 47 patients in the study group who received atorvastatin 20 mg/d and ezetimibe 10 mg/d per night. Serum TG as well as hepatic and renal function, serum creatine kinase levels were measured at baseline and after 4 weeks of treatment. Results TG levels were significantly decreased in both groups after 4 weeks of treatment compared to those at baseline （P〈0.01）. The decrease of TG was significantly greater in the study group than that in the control group （P〈0.01）. Conclusion For patients with UA, the combination of atorvastatin 20 mg/d and ezetimibe 10 mg/d is more effective in lowering TG levels than atorvastatin 20 mg/d alone. The combination is safe and well tolerated by patients.