摘要
目的研究依折麦布与阿托伐他汀联合应用在调脂治疗不达标急性心肌梗死患者中的应用与临床效果。方法将178例符合急性心肌梗死(AMI)诊断的患者,给予阿托伐他汀钙20 mg 14 d,每晚顿服,检测患者血脂水平,根据血脂水平分为血脂达标组(A组)82例和血脂未达标组96例,A组继续给予阿托伐他汀钙20 mg/d治疗至90 d;未达标组再随机分为B组48例和C组48例,其中B组继续阿托伐他汀钙20 mg/d治疗至90 d,C组联合应用阿托伐他汀钙20 mg/d和依折麦布10 mg/d,疗程为76 d。分别于基线(调脂治疗前)、调脂治疗14 d、调脂治疗90 d时检测所有患者血脂水平,包括血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和载脂蛋白B(ApoB)。结果178例急性心肌梗死患者治疗14 d后TC、LDL、ApoB水平均显著下降(P<0.05),HDL变化无统计学意义(P>0.05),血脂达标率46.1%(82/178)。B组患者继续调脂治疗至90 d与14 d时比较,TC、LDL均有下降趋势,但无统计学意义(P>0.05),HDL水平变化无统计学意义(P>0.05),ApoB显著上升(P<0.05),血脂达标率20.1%(10/48)。C组治疗至90 d时与14 d时比较,TC、LDL-C持续显著下降(P<0.05),HDL水平较前增高,差异有统计学意义(P<0.05),血脂达标率70.8%(34/48)。结论AMI患者在接受单独阿托伐他汀调脂治疗后仍不达标者,联合应用依折麦布,可显著降低血中胆固醇水平,减少胆固醇吸收,提高血脂达标率。
Objective To study the application and clinical efficacy of ezetimibe combined with atorvastatin in non-compliance patients with acute myocardial infarction(AMI)during lipid-regulating treatment.Methods AMI patients(n=178)were treated with atorvastatin calcium(20 mg)at draught every night for 14 d.The blood fat level was detected in all patient,and then they were divided,according to blood fat level,into compliance group(group A,n=82)and non-compliance group(n=96).Group A was continuously treated with atorvastatin calcium(20 mg/d)for 90 d.The non-compliance group was divided again into group B and group C(each n=48),and group B was continuously treated with atorvastatin calcium(20 mg/d)for 90 d and group C was treated with atorvastatin calcium(20 mg/d)and ezetimibe(10 mg/d)for 76 d.The indexes of blood fat level,including total cholesterol(TC),low-density lipoproteincholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C)and apolipoprotein B(ApoB)were detected in all groups at baseline(before regulating blood fat)and in 14 d and 90 d after lipid-regulating treatment.Results After treatment for 14 d,the levels of TC,LDL-C and ApoB decreased significantly(P<0.05)and HDL-C had no statistical changes(P>0.05)in all AMI patients(n=178),and the compliance rate of blood fat was 46.1%(82/178).In group B,after treatment for 90 d,the levels of TC and LDL-C had descending trend but had no statistical significance(P>0.05),HDL-C level had no statistical changes(P>0.05)and ApoB level increased significantly(P<0.05)compared with those after treatment for 14 d,and the compliance rate of blood fat was 20.1%(10/48).In group C,after treatment for 90 d,the levels of TC and LDL-C decreased significantly(P<0.05),HDL-C level increased(P<0.05)compared with those after treatment for 14 d,and the compliance rate of blood fat was 70.8%(34/48).Conclusion The therapy of atorvastatin combined with ezetimibe can significantly decrease cholesterol level,reduce cholesterol absorption and improve compliance rate of blood fat in AMI patients treated with atorvastatin combined with ezetimibe,who are not compliance after lipid-regulating treatment with only atorvastatin.
作者
吴永辉
任凤学
Wu Yonghui;Ren Fengxue(First Department of Cardiovascular Medicine,Aviation General Hospital,Beijing 100012,China)
出处
《中国循证心血管医学杂志》
2020年第4期464-466,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性心肌梗死
依折麦布
阿托伐他汀
血脂
达标率
Acute myocardial infarction
Ezetimibe
Atorvastatin
Blood fat
Compliance rate
