中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2013, Vol. 42 ›› Issue (11): 985–988.

• 论著 • 上一篇    下一篇

急性冠脉综合征合并2型糖尿病患者中联合降脂的效果

李露露,张敏丽,张大庆   

  1. 中国医科大学附属盛京医院心内科,沈阳110004
  • 收稿日期:2013-09-18 出版日期:2013-11-30 发布日期:2013-11-28
  • 作者简介:李露露(1989-),女,硕士研究生.
  • 基金资助:
    国家自然科学基金(81200199/H0215)

Combination Therapy Efficacy of Ezetimibe and Statins on Patients with both Acute Coronary Syndrome and Diabetes

LI Lu-lu,ZHANG Min-li,ZHANG Da-qing   

  1. Department of Cardiology,Shengjing Hospital,China Medical University,Shenyang 111004,China
  • Received:2013-09-18 Online:2013-11-30 Published:2013-11-28

摘要: 目的探索急性冠脉综合征(ACS)合并2型糖尿病(T2DM)患者早期联合降脂治疗对血脂、炎症指标的影响,并评价其安全性。方法ACS合并T2DM的患者84例,其中他汀单药治疗(他汀单药组)40例,他汀联合依折麦布治疗(联合治疗组)44例。随访1个月,观察血脂、超敏反应蛋白、肝功肾功及肌酶等。结果联合治疗组和他汀单药组7d后的低密度脂蛋白胆固醇(LDL-C)水平分别为(1.87#x000b1;0.42)和(2.18#x000b1;0.58)mmol/L(P=0.007),30d后分别为(1.51#x000b1;0.29)和(1.94#x000b1;0.49)mmol/L(P<0.001);以LDL-C水平降至1.8mmol/L或下降50%来计算达标率,30d后联合治疗组达标率显著优于他汀单药组(77%和45%,P=0.002)。治疗30d后,2组高密度脂蛋白胆固醇水平较基线水平均未见改善,甘油三酯水平和超敏C反应蛋白水平显著降低,但2组间无明显差异,且超敏C反应蛋白水平与血脂水平无相关性。2组在治疗过程中均未发现肝酶升高、肌病等不良反应。结论对于ACS合并T2DM患者在初始治疗时即可予依折麦布联合常规剂量他汀治疗,可在短时间内更大幅度的降低LDL-C,有效提高LDL-C达标率,且安全性良好。

关键词: 急性冠脉综合征, 糖尿病, 依折麦布, 他汀

Abstract: Objective To evaluate the effects and safety of combined use of ezetimibe with standard dose of statins in patients with both ACS and T2DM. Methods Patients with both ACS and T2DM were randomly divided into the standard dose group of statins (n=40) and the combination therapy group of ezetimibe and statins (n=44). In order to evaluate the clinical effects on lowering lipids,systemic inflammation response and clinical safety,follow up was carried out on day 7 and day 30,. Results The level of LDL-C in combination group and statins group are 1.87#x000b1; 0.42 vs2.18#x000b1; 0.58 mmol/L (P=0.007) on day 7,and 1.51#x000b1; 0.29 vs1.94#x000b1; 0.49 mmol/L (P<0.001) on day 30. Based on the guideline target of LDL-C reduction >50% or LDL-C level#x02264;1.8 mmol/L,the control rate of the combination group and the standard dose group of statins were 77% and 45% (P=0.002),respectively. On day 30,there was no significant improvement in HDL-C in both groups,neither significant difference of TG level nor hs-CRP level between two groups. No correlation exists between improvement of serum-lipid level and hs-CRP level. Conclusion Our study demonstrated that it is feasible to initiate combination therapy during acute phase for patients with both ACS and T2DM,which can bring more significant effects of lowering LDL-C with a good safety.

Key words: acute coronary syndrome, diabetes, statins, ezetimbe

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