依折麦布联合阿托伐他汀钙治疗高胆固醇血症的疗效观察

Observation on efficacy of ezetimibe combined with atorvastatin calcium in the treatment of hypercholesterolemia

目的 探讨高胆固醇血症应用依折麦布联合阿托伐他汀钙治疗的临床效果与安全性。方法 82例高胆固醇血症患者,按照计算机表法分为研究组和对照组,各41例。对照组实施阿托伐他汀钙治疗,研究组实施依折麦布+阿托伐他汀钙治疗。比较两组患者的血脂水平,治疗前后颈动脉斑块面积与颈动脉内中膜厚度(IMT),不良反应发生情况,谷草转氨酶(AST)、谷丙转氨酶(ALT)、肌酸激酶(CK)水平。结果 研究组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]水平分别为(4.56±0.41)mmol/L、(2.62±0.40)mmol/L、(1.49±0.22)g/L、(0.33±0.10)g/L,显著低于对照组的(5.31±0.52)mmol/L、(3.12±0.44)mmol/L、(1.61±0.27)g/L、(0.38±0.11)g/L,差异有统计学意义(P<0.05);两组高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)水平比较,差异无统计学意义(P>0.05)。治疗后,研究组颈动脉斑块面积与IMT分别为(0.72±0.11)cm^(2)、(0.71±0.02)mm,小于对照组的(0.98±0.11)cm^(2)、(0.95±0.03)mm,差异有统计学意义(P<0.05)。研究组不良反应发生率9.76%低于对照组的29.27%,差异有统计学意义(P<0.05)。研究组AST、ALT、CK水平分别为(32.21±4.62)、(21.67±6.51)、(51.26±8.67)U/L,低于对照组的(35.21±5.42)、(24.91±5.38)、(57.31±13.29)U/L,差异有统计学意义(P<0.05)。结论 依折麦布联合阿托伐他汀钙治疗高胆固醇血症的效果显著,不仅能够改善颈动脉斑块面积与IMT,还能降低不良反应发生率,值得临床应用。

Objective To discuss the clinical effect and safety of ezetimibe combined with atorvastatin calcium in the treatment of hypercholesterolemia.Methods A total of 82 patients with hypercholesterolemia were divided into the study group and the control group according to computer table method,with 41 cases in each group.The control group was treated with atorvastatin calcium,and the study group was treated with ezetimibe+atorvastatin calcium.Both groups were compared in terms of blood lipid levels,carotid plaque area and intima-media thickness(IMT),occurrence of adverse reactions,and levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and creatine kinase(CK)before and after treatment.Results The levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB),and lipoprotein(a)[Lp(a)]in the study group were(4.56±0.41)mmol/L,(2.62±0.40)mmol/L,(1.49±0.22)g/L,and(0.33±0.10)g/L,which were significantly lower than those of(5.31±0.52)mmol/L,(3.12±0.44)mmol/L,(1.61±0.27)g/L,and(0.38±0.11)g/L in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of high density lipoprotein cholesterol(HDL-C)and triglyceride(TG)between the two groups(P>0.05).After treatment,the carotid plaque area and IMT of the study group were 22(0.72±0.11)cm and(0.71±0.02)mm,which were less than those of(0.98±0.11)cm and(0.95±0.03)mm of the control group,and the difference were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 9.76%,which was lower than that of 29.27%in the control group,and the difference was statistically significant(P<0.05).The levels of AST,ALT and CK in the study group were(32.21±4.62),(21.67±6.51)and(51.26±8.67)U/L,which were lower than those of(35.21±5.42),(24.91±5.38)and(57.31±13.29)U/L in the control group,and the differences were statistically significant(P<0.05).Conclusion Ezetimibe combined with atorvastatin calcium has significant effect in the treatment of hypercholesterolemia,which can not only improve carotid plaque area and IMT,but also reduce the incidence of adverse reactions,which is worthy of clinical application.