瑞舒伐他汀与依折麦布联用治疗急性冠脉综合征临床观察  

Clinical observation of rosuvastatin combined with ezetimibe in the treatment of acute coronary syndrome

作　　者：伏开全 李群星 张扬阳 熊政 赵新华[2] 尹德录[2] FU Kai-quan;LI Qun-xing;ZHANG Yang-yang;XIONG Zheng;ZHAO Xin-hua;YIN De-lu(Menhe Hospital of Ganyu Distract,Lianyungang 222135,P.R.China;Department of Cardiology First People's Hospital of Lianyungang,Lianyungang 222002,P.R.China)

机构地区：[1]江苏省连云港市赣榆区门河卫生院,江苏连云港222135 [2]连云港市第一人民医院心内科,江苏连云港222002

出　　处：《社区医学杂志》2018年第21期1604-1607,共4页Journal Of Community Medicine

摘　　要：目的在急性冠脉综合征(acute coronary syndrome,ACS)患者中直接联合应用他汀类药物和依折麦布是一种强化降脂方案,但其疗效和安全性观察并不充分,本研究对比观察ACS患者单用瑞舒伐他汀或联合使用依折麦布两种方案的治疗效果、安全性及短期预后。方法选择2016-02-01-2016-12-31连云港市第一人民医院心内科住院的76例急性冠脉综合征患者作为研究对象,分为两组。单药治疗组37例,给予瑞舒伐他汀10mg/d;联合治疗组39例,给予瑞舒伐他汀10mg/d和依折麦布10mg/d。治疗3个月,观察两组血脂水平、肝肾功能、各炎症指标水平变化情况和主要心血管不良事件(major adverse cardiac events,MACE)发生率。结果联合治疗组在接受治疗后,超敏C反应蛋白(hy-persensitive C-reactive protein,hs-CRP)水平为(4.31±1.54)mg/L,显著低于单药治疗组的(5.29±1.75)mg/L,差异有统计学意义,t=2.595,P=0.011;治疗后联合治疗组内皮素-1(endothelin-1,ET-1)水平为(42.89±16.91)ng/L,显著低于单药治疗组的(54.48±17.99)ng/L,差异有统计学意义,t=2.895,P=0.005;治疗后两组血谷丙转氨酶分别为(28.77±8.53)和(29.51±9.49)U/L,肌酐分别为(72.36±14.51)和(76.73±14.43)μmol/L,差异均无统计学意义,P值分别为0.722和0.192。单药治疗组接受治疗后再次发生心绞痛3例(0.77%),低于联合治疗组的10例(27.03%),差异有统计学意义,χ2=4.940,P=0.026;单药治疗组接受治疗后再发心肌梗死1例(2.56%),显著低于单药治疗组的7例(18.92%),差异有统计学意义,χ2=5.321,P=0.021。结论与单药治疗相比,瑞舒伐他汀与依折麦布联用治疗急性冠脉综合征可以使患者的血脂指标改善更显著,血管炎症反应指标控制更好,预后更佳。OBJECTIVE In patients with acute coronary syndrome( ACS),direct combination of statins and ezetimibe is an enhanced lipid-lowering regimen.But its efficacy and safety are not well observed.In this study,the efficacy,safety and short-term prognosis of either rosuvastatin alone or combined with ezetimibe in patients with ACS are compared.METHODS From February 1 to December 31 in 2016,76 ACS hospitalization patients were divided into two groups in department of cardiology of Lianyungang First Peoplef s Hospital.Thirty-seven patients in the monotherapy group were given rosuvastatin 10 mg/d, 39 patients in combined treatment group were given ezetimibe 10 mg/d and rosuvastatin 10 mg/d.After 3 months of treatment,the blood lipid level,liver and kidney function,the changes of inflammatory indexes and the incidence of major cardiovascular adverse events(MACE) were observed.RESULTS After treatment,the level of hypersensitive C reactive protein(hs-CRP) in the combined treatment group was (4.31±1.54) mg/1,which was significantly lower than that in the monotherapy group (5.29±1.75) mg/l.The difference was statistically significant (t=2.595,P=0.011).The level of endothelin-1 ( ET-1) in the combined treatment group (42.89 ± 16.91) ng/l was significantly lower than that in the monotherapy group (54.48 ± 17.99) ng/l.After treatment, the serum alanine aminotransferase levels were (28.77 ±8.53) and ( 29.51± 9.49) U/l, respectively, and creatinine were (72.36±14.51) and (76.73±14.43)μmol/l,respectively.P values were 0.722 and 0.192,respectively.Angina pectoris occurred again in 3 cases( 0.77%) in the monotherapy group, which was lower than that in 10 cases (27.03%) in the combined treatment group.The difference was statistically significant(χ^2=4.940, P=0.026).One case(2.56%) had recurrent myocardial infarction after treatment, which was significantly lower than that in monotherapy group with 7 cases (18.92%).The difference was statistically significant (χ^2=5.321,P=0.021).CONCLUSION Compared with the monotherapy strategy

关 键 词：急性冠状动脉综合征 瑞舒伐他汀 依折麦布 血脂 

分 类 号：R543.3[医药卫生—心血管疾病]