强化他汀治疗与他汀联合依折麦布降脂疗效比较

Effects of intensive statin therapy and statin combined with ezetimibe on lipid-lowering

目的探讨强化他汀治疗与他汀联合依折麦布降脂疗效的差异。方法选取我院全科门诊2016年1月-2018年12月收治稳定性冠心病患者160例。采用计算机随机数法随机分组为40mg阿托伐他汀联合10mg依折麦布组和40mg阿托伐他汀组,每组各80例。随访并比较两组患者血脂改变情况以及主要心血管不良事件(Major adverse cardiovascular events, MACEs)的发生。结果与基线相比,第3月时两组患者甘油三酯(triglyceride, TG)、总胆固醇(total cholesterol, TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)均降低(P<0.05)。两组TG降低情况差异无统计学意义(P>0.05)。阿托伐他汀联合依折麦布治组TC、LDL-C显著低于强化他汀治疗组,差异具有统计学意义(P<0.05)。随访期间无患者失访。共发生18例MACEs,其中联合治疗组10例(复发性心绞痛6例,心力衰竭4例,无卒中及死亡病例);强化他汀组8例(复发性心绞痛5例,心衰3例,无卒中及死亡发生),两组差异无统计学意义(P>0.05)。结论相较于40mg阿托伐他汀,40mg阿托伐他汀联合10mg依折麦布对稳定性冠心病患者的降脂疗效更优。

Objective To investigate the different effects of intensive statin therapy and statin combined with ezetimibe on lipid-lowering.Methods One hundred and sixty patients with stable coronary heart disease in our hospital from January 2016 to December 2018 were included.The patients were randomly divided into 40 mg atorvastatin combined with 10 mg ezetimibe group or 40 mg atorvastatin group by the ratio of 1∶1.The changes of blood lipid and the occurrence of major adverse cardiovascular events(MACEs)were compared between the two groups.Results There were 59 males(73.8%)with an average age of(60.7±7.1) years old in the combined treatment group, and 61(76.3%)males with an average age of(60.1±6.8) years old in the intensive statin group.There were no significant differences in age, sex, prevalence of hypertension, stroke and diabetes, cardiovascular therapy drugs, and baseline lipid levels between the two groups(P>0.05).Compared with baseline, the levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)were significantly decreased in both lipid-lowering therapies after 3 month′ treatment.However, there was no significant difference in the decrease of TG between the two groups(P>0.05).The treatment of atorvastatin combined with ezetimeprazole decreased more TC,LDL-C than intensive statintherapy(P<0.05).No patients were lost to follow up.There were 18 cases of MACEs, including 10 case in the combined treatment group(6 cases of recurrent angina pectoris, 4 case of heart failure, no stroke and death);8 cases in the intensive statin group(5 cases of recurrent angina pectoris, 3 cases of heart failure, no occurrence of stroke and death),there was no significant different occurrence rate between the two groups(P>0.05).Conclusion 40 mg atorvastatin combined with 10 mg ezetimibe is more effective than compared with 40 mg atorvastatin in reducing blood lipid in patients with stable coronary heart disease.