探讨阿托伐他汀联合依折麦布对冠脉支架术后单用阿托伐他汀LDL-C未达标患者的血脂水平及炎性因子的影响

Exploring the Effect of Atorvastatin Combined with Ezetimibe on Lipid Levels and Inflammatory Factors in Patients with Substandard LDL-C on Atorvastatin Alone After Coronary Stenting

目的评估阿托伐他汀+依折麦布应用在冠脉支架术后单用阿托伐他汀且低密度脂蛋白胆固醇(Low Density Lipoprotein Cholesterol,LDL-C)未达标患者中的效果及对血脂水平、炎性因子的影响。方法选取2022年1月—2023年7月庆阳市第二人民医院收治的88例冠脉支架术后单用阿托伐他汀且LDL-C未达标(≥1.8 mmol/L)的患者为研究对象,以随机数表法分为对照组(n=44,给予阿托伐他汀治疗)、观察组(n=44,给予阿托伐他汀+依折麦布治疗)。评价两组患者的血脂水平、血管内皮功能、炎性因子水平及用药安全性。结果治疗前,两组患者的血脂水平[包括高密度脂蛋白(High Density Lipoprotein,HDL-C)、LDL-C、三酰甘油(Triglyceride,TG)、总胆固醇(Total Cholesterol,TC)]、血管内皮功能[一氧化氮(Nitric Oxide,NO)、内皮素-1(Endothelin-1,ET-1)]、炎性因子[超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor Necrosis Factor-alpha,TNF-α)]对比,差异无统计学意义(P均>0.05)。治疗12周后,两组患者的HDL-C、TG水平以及不良反应发生率对比,差异无统计学意义(P均>0.05);观察组患者的LDL-C水平为(1.83±0.17)mmol/L,低于对照组的(2.09±0.23)mmol/L,差异有统计学意义(t=6.030,P<0.05);另外,观察组患者的TC、ET-1、hs-CRP、IL-6、TNF-α水平较对照组更低,NO较对照组更高,差异有统计学意义(P均<0.05)。结论对冠脉支架术后单用阿托伐他汀且LDL-C未达标患者采用阿托伐他汀+依折麦布治疗,安全性高,并且可以有效调节血脂,降低炎性因子水平,改善血管内皮功能。

Objective To evaluate the effect of atorvastatin+ezetimibe application in patients with atorvastatin alone and substandard low density lipoprotein cholesterol(LDL-C)after coronary stenting,and the effect on lipid levels and inflammatory factors.Methods Eighty-eight patients with atorvastatin alone and substandard LDL-C(≥1.8 mmol/L)after coronary stenting in Qingyang Second People's Hospital from January 2022 to July 2023 were selected as re⁃search objects.They were divided into a control group(n=44,treated with atorvastatin)and an observation group(n=44,treated with atorvastatin+ezetimibe)using a random number table method.Lipid levels,vascular endothelial func⁃tion,inflammatory factors,and safety were evaluated between the two groups of patients.Results Before treatment,There was no statistically significant difference in lipid levels[including high-density lipoprotein(HDL-C),LDL-C,triglyceride(TG),and total cholesterol(TC)],vascular endothelial function[including nitric oxide(NO)and endothelin-1(ET-1)],and inflammatory factors[including hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]between the two groups of patients(all P>0.05).After 12 weeks of treatment,there was no statistically significant difference in the levels of HDL-C,TG,and adverse reactions between the two groups(all P>0.05).The LDL-C level in the observation group was(1.83±0.17)mmol/L,which was lower than that in the con⁃trol group(2.09±0.23)mmol/L,and the difference was statistically significant(t=6.030,P<0.05).In addition,the lev⁃els of TC,ET-1,hs CRP,IL-6,and TNF-αin the observation group were lower than that of the control group,and the NO level was higher than that of the control group,and the differences were statistically significant(all P<0.05).Conclusion The use of atorvastatin+ezetimibe in patients with atorvastatin alone and substandard LDL-C after coro⁃nary stenting is safe and can effectively regulate blood lipids,reduce the level of inflammatory factors,and improve the function of the vascular endothelium.