依折麦布联合氟伐他汀对动脉粥样硬化性脑梗死患者血脂四项及Apo-B、hs-CRP水平的影响  

Effects of Ezetimibe Combined with Fluvastatin on the Levels of Blood Lipid and Apo-B and hs-CRP in Patients with Atherosclerotic Cerebral Infarction

作　　者：晏子俊[1] 张良明[1] 徐关丽[1] 陈彦清[1] 张月辉[1] 徐文豪 袁晓燕[1] 徐兴梦 YAN Zijun;ZHANG Liangming;XU Guanli;CHEN Yanqing;ZHANG Yuehui;XU Wenhao;YUAN Xiaoyan;XU Xingmeng(Panzhihua Central Hospital,Sichuan Panzhihua 617067,China)

机构地区：[1]攀枝花市中心医院

出　　处：《中国医药导刊》2019年第11期669-673,共5页Chinese Journal of Medicinal Guide

基　　金：心血管健康研究院-中国心血管健康联盟血脂异常及动脉粥样硬化研究基金(项目编号:2017-CCA-Msdlipid-003;项目名称:依折麦布联合氟伐他汀对脑梗死患者的临床疗效研究);四川省医学会高血压疾病(施慧达)专项科研课题(项目编号:2018SHD2-7;项目名称:苯磺酸左旋氨氯地平对糖尿病微血管病变合并高血压患者血压控制及血管内皮功能的影响)

摘　　要：目的:探讨依折麦布联合氟伐他汀对动脉粥样硬化性脑梗死患者血脂四项总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及载脂蛋白B(Apo-B)、超敏C反应蛋白(hs-CRP)水平的影响。方法:选取2017年7月至2018年6月于我院神经内科住院确诊的150例脑梗死患者为研究对象,随机分为对照组和观察组,每组75例。所有患者均给予常规药物治疗,包括给予抗血小板聚集药物,合并高血压与糖尿病患者给予对应药物治疗,同时指导患者戒烟,并低脂饮食。对照组单用氟伐他汀钠胶囊治疗;观察组联用氟伐他汀钠胶囊和依折麦布片。分析两组患者治疗前、治疗后3个月、治疗后6个月血脂四项TC、TG、LDL-C、HDL-C水平变化;治疗前、治疗后6个月的Apo-B和hs-CRP水平变化;治疗前后颈动脉粥样斑块横切面最大面积(Smax)及不良反应。结果:治疗前,两组患者的血脂四项水平差异均无统计学意义(P>0.05);治疗后3个月、6个月,两组患者的TC、TG、LDL-C均比治疗前降低,且治疗后6个月低于治疗后3个月(P<0.05);组间比较,观察组TC、LDL-C降低程度大于对照组(P<0.05);TG、HDL-C差异均无统计学意义(P>0.05)。治疗前,两组患者的Apo-B、hs-CRP水平差异无统计学意义(P>0.05);治疗后6个月,两组患者的Apo-B、hs-CRP水平均降低,且观察组低于对照组(P<0.05)。治疗前两组的Smax差异无统计学意义(P>0.05);治疗后两组患者的Smax均有降低,且观察组比对照组降低幅度大,但差异无统计学意义(P>0.05)。两组患者的不良反应率差异无统计学意义(P>0.05)。结论:依折麦布联合氟伐他汀能改善动脉粥样硬化性脑梗死患者的血脂代谢情况,降低炎性反应,临床效果更佳且不会产生严重不良反应,安全性高。Objective:To investigate the effects of ezetimibe combined with fluvastatin on the levels of blood lipids(TC,TG,LDL-C,HDL-C)and Apo-B,hs-CRP in patients with atherosclerotic cerebral infarction.Methods:150 patients with cerebral infarction(all accompanied by carotid atherosclerosis plaque and hyperlipidemia)diagnosed in the department of neurology of our hospital from July 2017 to June 2018 were randomly divided into the control group and observation group,75 cases in each group.All patients were given routine medication,including anti-platelet aggregation,corresponding medication for patients with hypertension and diabetes,and guidance for smoking cessation and low-fat diet.On the basis of the above,the control group was treated with fluvastatin sodium capsules alone,while the observation group was treated with fluvastatin sodium capsules combined with ezetimibe tablets.The levels of TC,TG,LDL-C and HDL-C in blood were analyzed before treatment,3 months and 6 months after treatment.Apo-B and hs-CRP before and 6 months after treatment,Smax of carotid atherosclerotic plaque before and after treatment and adverse reactions of the two groups were compared.Results:Before treatment,there was no significant difference in blood lipid levels between the two groups(P>0.05).After 3 months and 6 months of treatment,TC,TG and LDL-C of the two groups were lower than before treatment,and at 6 months after treatment were lower than at 3 months after treatment(P<0.05).Compared with the control group,the degree of reduction of TC and LDL-C in the observation group was greater than that in the control group(P<0.05).TG and HDL-C had no significant change(P>0.05).Before treatment,there was no difference in the levels of Apo-B and hs-CRP between the two groups(P>0.05).6 months after treatment,the levels of Apo-B and hs-CRP in both groups decreased,and the observation group was lower than the control group(P<0.05).There was no significant difference in Smax between the two groups before and after treatment(P>0.05).Smax in the observat

关 键 词：依折麦布 氟伐他汀 动脉粥样硬化性脑梗死 血脂四项 APO-B hs-CRP 

分 类 号：R541.4[医药卫生—心血管疾病]