辛伐他汀联合非诺贝特治疗老年2型糖尿病并混合型高脂血症患者的临床疗效观察  

Curative Effect of Simvastatin Combined with Fenofibrate on Senile Patients with Type 2 Diabetes and Hyperlipidemia

作　　者：彭顺刚 卢建刚[2] 余灿 刘仁海 刘洪 刘晓春 Peng Shungang Lu Jianggang Yu Can Liu Renhai Liu Hong Liu Xiaochun(Department of Internal Medicine, the People＇s Hospital of Wulong County, Chongqing, 408500 Department of Geratology, Fuling Central Hospital of Chongqing City, 408000 Department of Respiration, the People＇s Hospital of Wulong County, Chongqing, 408500, P. R. China)

机构地区：[1]重庆市武隆县人民医院内科,重庆武隆408500 [2]重庆市涪陵中心医院老年病科 [3]重庆市武隆县人民医院呼吸科,重庆武隆408500

出　　处：《西南军医》2017年第2期112-116,共5页Journal of Military Surgeon in Southwest China

摘　　要：目的探讨辛伐他汀联合非诺贝特治疗老年2型糖尿病并混合型高脂血症患者的疗效和安全性,并观察主要心血管事件发生情况。方法 65岁以上老年2型糖尿病并混合型高脂血症患者198例,随机分为单用辛伐他汀片组(单药组)95例,给予辛伐他汀片20mg/d;辛伐他汀片联合非诺贝特胶囊组(联合组)103例,给予辛伐他汀片20mg/d,非诺贝特胶囊100mg/d。疗程均为6个月。观察两组治疗前和治疗后1、3、6个月血脂参数变化,达标率、不良反应及主要心血管事件例数。结果单药组除三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)治疗后与治疗前无明显改善外(P>0.05),血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均有明显降低(P<0.05)。联合组TG、TC及LDL-C治疗后均有显著降低,HDL-C明显升高(P<0.05);与单药组比较,联合组TG、TC及LDL-C降低的幅度和HDL-C升高幅度更大(P<0.05或P<0.01),治疗后3、6个月,联合组TG、TC、LDL-C、HDL-C达标率和四项达标率更高(P<0.05);心血管事件较单药组明显减少,差异有统计学意义(χ~2=12.78,P<0.01);两组患者不良反应发生率相比差异无统计学意义(χ~2=0.28,P>0.05)。结论辛伐他汀联合非诺贝特治疗老年2型糖尿病并混合型高脂血症患者有良好的安全性和有效性,能减少主要心血管事件发生。Objective To discuss the curative effect of simvastatin combined with fenofibrate on senile patients with type 2 diabetes and mixed hyperlipidemia and the safety and to oberve the occurrence of main cardiovascular events. Methods 198 senile patients over65 years old with type 2 diabetes and mixed hyperlipidemia were randomly divided into 2 groups： single group（n=95） and combined group（n=103）; administration of simvasatin, 20mg/d, was applied to all the patients in both groups while fenofibrate, 100mg/d, was added to patients in combined group; the treatment in both groups lasted for 6 months; an observation was made to the changes of blood lipid index, standard-reaching rate, the occurrence of side effects and case number of main cardiovascular events. Results The levels of TG and HDL-C in patients in single group was not obviously improved before and after treatment（P〉0.05） but the levels of TC and LDL-C after treatment were lower than those before treatment（P〉0.05）; the levels of TG, TC and LDL-C of the patients in combined group were much lower after treatment than those before treatment while level of HDL-C increased obviously（P〉0.05）; the decrease of the levels of TG, TC and LDL-C and the increase of the level of HDL-C in combined group were bigger than those in single group（P〉0.05 or P〉0.05）; the standard-reaching rates of TG, TC, LDL-C and HDL-C in combined group 3 and 6 months after treatment were higher than those in single group（P〉0.05）; the occurrence of main cardiovascular events in combined group decreased much more than that in single group, the difference between the 2 groups was of statistical significance（χ~2=12.78, P〉0.01）; there existed no statistical difference in the occurrence of side effects between the 2 groups（χ~2=0.28, P〉0.05）. Conclusions Simvatatin combined withfenofibrate is effective with safety on senile patients with type 2 diabetes and mixed hyperlipidemia, which can reduce the occurrence of main cardiovascular events.

关 键 词：辛伐他汀 非诺贝特 混合型高脂血症 血脂异常 血管剩留风险 

分 类 号：R587.1[医药卫生—内分泌]