依折麦布联合阿托伐他汀对脑梗死患者血脂及血浆纤维蛋白原的影响

Effects of ezetimibe combined with atorvastatin on blood lipids and fibrinogen in patients with cerebral infarction

目的观察依折麦布联合阿托伐他汀对脑梗死患者血脂水平、血浆纤维蛋白原的影响。方法将92例符合诊断标准的脑梗死患者按随机数字表法随机抽取分为3组,即联合A组(27例)、联合B组(35例)、对照组(30例)。联合A组给予依折麦布10 mg+阿托伐他汀20 mg,联合B组给予依折麦布10 mg+阿托伐他汀10 mg,对照组给予阿托伐他汀20 mg。观察3组治疗前后血脂水平[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]和纤维蛋白原浓度变化及血脂达标率、不良反应情况。结果治疗8周后,联合A组、联合B组、对照组TC、LDL-C水平比治疗前降低(t=4.33、4.29;t=3.86、3.78;t=3.61、3.45,P<0.05),且治疗后联合A组<联合B组<对照组(q=3.38、3.41,P<0.05;q=4.30、4.39,P<0.01);而HDL-C水平升高,且联合A组>联合B组>对照组(q=3.37,P<0.05;q=4.33,P<0.01)。联合A组、联合B组、对照组治疗后血浆纤维蛋白原均较治疗前降低(t=3.83、3.75、3.71,P<0.05),且联合A组、联合B组均低于对照组(q=3.71、3.38,P<0.05)。治疗8周后,联合A组、联合B组和对照组达标率分别为40.7%、34.3%和30.0%,联合A组>联合B组>对照组(X^2=15.36,P<0.05;X^2=18.92,P<0.01)。结论依折麦布与阿托伐他汀联合使用能更有效地降低TC、LDL-C水平,同时还能有效地降低纤维蛋白原浓度,且大剂量阿托伐他汀(20 mg)优于小剂量(10 mg),使脑梗死患者及高危人群更多获益。

Objective To observe the effect of ezetimibe combined with atorvastatin on blood lipid levels,plasma fibrinogen in patients with cerebral infarction.Methods Ninty-two cases of cerebral infarction patients diagnozed according to diagnosis criteria were randomly divided into 3 groups using random digital table,the combined A group(27 cases),combined B group(35 cases),control group(30 cases).Combined A group was given ezetimibe 10 mg and atorvastatin 20 mg,combined B group was given ezetimibe 10 mg and atorvastatin 10 mg,while the control group was given atorvastatin 20 mg.Serum lipid levels before and after treatment in the 3 groups[total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and fibrinogen concentration changes and the success rate of reaching the normal level of blood lipids,adverse reaction were observed.Results After 8 weeks' treatment,TC and LDL-C levels in combined A group,combined B group,control group were decreased than before treatment(t = 4.33,4.29;t-3.86,3.78;t = =3.61,3.45,P <0.05),and the TC and LDL-C levels after treatment was in the order of combined A group < combined B group < control group(q = 3.38,q = 3.41,P < 0.05;q = 4.30,q =4.39,P <0.01);while the HDL-C levels was increased in the order of combined A group > combined B group > control group(q =3.37,P <0.05;q =4.33,P <0.01).After treatment,plasma protein fiber were decreased in all of the three groups(t = 3.83,3.75,3.71,P < 0.05),and the combined A group and combined B group were lower than that in control group(q =3.71,3.38,P <0.05).After 8 weeks of treatment,combined A group,combined B group and control group' s lipid reaching normal rates were40.7%,34.3%and 30%,with the order of combined A group > combined B group > control group(x^2 = 15.36,P < 0.05;x^2 =18.92,P <0.01).Conclusion Combination of ezetimibe and atorvastatin can more effectively reduce the TC,LDL-C level,while also can effectively reduce the concentration of fibrinogen which can benefit the cerebral infarction patients and high-risk patients.