摘要
目的:探讨联合应用辛伐他汀和非诺贝特对急性冠脉综合征(ACS)患者血脂参数及炎症因子的影响。方法:共入选58例ACS患者,随机分为:辛伐他汀组(20mg/d,18例);非诺贝特组(200mg/d,18例);联合治疗组(辛伐他汀20mg/d+非诺贝特200mg/d,22例),疗程均为6个月。观察治疗前、后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、一氧化氮(NO)、内皮素(ET)和C反应蛋白(CRP)含量的变化,以及药物不良反应。结果:各组治疗后血清TC、LDL-C、TG水平显著降低(P均<0.05),血清HDL-C水平有不同程度增高,其中以联合治疗组最为明显(P均<0.05)。和辛伐他汀组相比,非诺贝特组TC和LDL-C水平无明显差异(P>0.05),而TG水平显著降低,HDL-C水平明显增高(P<0.05),与治疗前相比,各组治疗后血清NO水平增高,CRP和ET水平降低(P<0.05),联合治疗组较辛伐他汀组、非诺贝特组更显著(P均<0.05),三组均无不良反应。结论:联合辛伐他汀和非诺贝特治疗可以更全面地改善ACS患者的血脂异常,其改善内皮功能和降低炎症因子的作用较单药治疗更有效。
Objective： To investigate the influences of combination therapy with fenofibrate and simvastatin on blood fat and vascular endothelial function in patients with acute coronary syndrome （ACS）. Methods： A total of 58 ACS patients were randomly divided into three groups： simvastatin group （20mg/d, n= 18）, fenofibrate group （200rag/d, n = 18）, combined therapy group （20mg/d simvastatin ＋ 200mg /d fenofibrate n= 22）. All groups were follow-up 6 months. The levels of total cholesterol （TC）, low density lipoprotein （LDL） --cholesterol, triglycerides （TG）, high density lipoprotein （HDL） -cholesterol as well as nitric oxide （NO）, endothelin （ET） and C--reactive protein （CRP） were measured before and after treatments. In addition, adverse effects were observed. Results： After treatment the TC, LDL and TG levels significantly decreased （P〈0.05） in every group, and HDL increased （P〈0.05）. Compared with simvastatin alone group or fenofibrate alone group, the TC, LDL and TG levls of combined group were signifi- cantly lower and HDL were significantly higher （P〈0.05 all）. There were no significant differences of TC and LDL between simvastatin alone group and fenofibrate group, but TG significantly decreased （P〈0.05） and HDL significantly increased in fenofibrate group （P〈0.05） . Compared with the baseline, serum C--reactive protein （CRP） and ET levels significantly decreased after treatment in every group （P〈0.05）. Compared with simvastatin group and fenofibrate group, the NO level of combined group was significantly higher, CRP and ET levels were significantly low- er （P〈0.05 all）. There was no statistical difference for adverse events between combination therapy and monotherapy group. Conclusion： Simvastatin combined with fenofibrate can more effectively normalize the lipids, and inhibit inflammatory response in patient with ACS.
出处
《心血管康复医学杂志》
CAS
2008年第5期499-502,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
