依折麦布联合阿托伐他汀钙治疗腹膜透析患者高脂血症的观察  

Observation of ezetimibe combined with atorvastatin calcium therapy in peritoneal dialysis patients with hypercholesterolemia

作　　者：陈文莉[1] 徐力[1] 毛辉辉[1] 李永霞[1] 

机构地区：[1]武汉市中心医院肾内科

出　　处：《临床肾脏病杂志》2015年第3期161-164,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨依折麦布联合阿托伐他汀钙治疗腹膜透析患者高脂血症的疗效及安全性。方法回顾性分析34例腹膜透析患者的临床资料，所有患者均行持续非卧床腹膜透析（continuous ambulatory peritoneal dialysis，CAPD），口服依折麦布（10mg／d）联合阿托伐他汀钙（10mg／d）治疗12周，检测用药前、后患者血脂、肝功能、肌酸磷酸激酶（creatine phosphokinase，CPK）及超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）的水平，并进行相关统计学分析。结果①在进行腹膜透析前，34例患者中有21例（占61．8％）存在高脂血症，其中高胆固醇血症6例（占17．6％），高三酰甘油（triacylglycerol，TG）血症5例（占14．7％），混合型高脂血症10例（占29．4％），而高胆固醇血症在原发病为糖尿病肾病患者中发病率较高，为14例（占41．2％）；②经过12周联合治疗，与治疗前比较，治疗后患者的血清总胆固醇（totalcholesterol，TC）、低密度脂蛋白胆固醇（low density lipoprotein cholesterin，LDL-C）、hs-CRP水平均有所降低，且差异均有统计学意义（P〈0．05）。另外，虽然TG水平较前有所降低，高密度脂蛋白胆固醇（high density lipoprotein cholesterin，HDL-C）水平较前有所升高，但差异均无统计学意义（P〉0．05）；丙氨酸氨基转移酶（alanine transaminase，ALT）、天冬氨酸氨基转移酶（aspartate transaminase，AST）、CPK水平较前并无明显变化；③34例患者经过12周联合治疗后，观察其治疗前、后的血清尿素氮（BUN）及肌酐（SCr）、尿量、腹膜透析超滤量、家庭自测血压的变化情况发现SCr有下降趋势，尿量有增加趋势，但差异并无统计学意义（P〉0．05），其余指标未见明显变化。结论依折麦布联合阿托伐他汀钙能有效治疗CAPD患者高胆固醇血症，且能降低hs—CRP水平，发挥抗炎作用，同时对患者的腹�Objective To explore the efficacy and safety of ezetimibe combined with atorvastatin calcium therapy in peritoneal dialysis patients with hypercholesterolemia. Methods A retrospective anal- ysis was conducted on the clinical data of 34 peritoneal dialysis patients with hypercholesterolemia. All pa- tients were subjected to continuous ambulatory peritoneal dialysis （CAPD）, and administered orally ezetimibe（10 mg/day）plus atorvastatin calcium（10 mg/day）for 12 weeks. Blood lipids, liver function, creatine phosphokinase（CPK） and high-sensitivity C-reactive protein （hs-CRP） levels were measured be- fore and after the treatment by statistical analysis. Results （ 1 ） Twenty-one out of 34 cases presented with hyperlipidemia（61.8% ） before peritoneal dialysis, among them, there were 6 cases of hypercholes- terolemia（17. 6%）, 5 cases of hypertriglyceridemia（14. 7%）, and 10 cases of combined hyperlipidemia （29.4 % ）. Besides, the incidence of hyperlipidemia was higher in the patients with diabetic nephropathy （14 cases, 41.2%）; （2）After combined treatment for 12 weeks, the serum total cholesterol（TC）, low-density lipoprotein cholesterol（LDL-C）, high-sensitivity CRP were reduced significantly as compared with those before treatment（P〈 0. 05）, but there was no significant difference in triglyceride （TG）,high-density lipoprotein cholesterol （HDL-C）, alanine transaminase （ALT）, aspartate transarninase （AST） and CPK before and after treatment （P〉0. 05） ; （3）Before and after treatment, blood urine ni- trogen （BUN）, ereatinine（Cr）, urine output, peritoneal ultrafiltration and home blood pressure in 34 patients were observe＆ It was found that there was significant difference in the above indexes before and after treatment （P〉 0.05）. Conclusions Ezetimibe combined with atorvastatin calcium can effectively reduce the cholesterol level of peritoneal dialysis patients with hypercholesterolemia, and can bring down the high-sensitivity

关 键 词：腹膜透析 胆固醇 治疗 

分 类 号：R589.2[医药卫生—内分泌] R692.5[医药卫生—内科学]