论文部分内容阅读
目的:观察他汀单用和他汀联合依折麦布对经皮冠状动脉介入(PCI)术后患者的调脂疗效和安全性以及短期预后影响。方法:将90例住院已行择期PCI的慢性稳定性心绞痛患者随机分为3组,分别给予辛伐他汀40mg/d(SI组,30例)、辛伐他汀20mg/d+依折麦布10mg/d(SI/EZ组,30例)和阿托伐他汀20mg/d(AT组,30例)治疗,随访12周。主要终点观察调脂疗效和药物不良反应及LDL-C达标率,次要终点观察3组患者PCI术后12周内主要不良心血管事件(MACE)发生率。结果:①3种调脂方案均能明显降低LDL-C、TC、TG和超敏C反应蛋白水平,同时提高HDL-C水平,且3组患者的LDL-C达标率组间比较差异无统计学意义。12周时,联合治疗组(SI/EZ组)LDL-C降低幅度(32.2%)和TG下降幅度(29.5%)均高于2个单药治疗组(SI组和AT组)(均P<0.05)。②3组均未出现有临床意义的肝酶和肌酶升高,且联合治疗组常见不良反应发生率较低。③PCI术后12周内3组MACE发生率差异无统计学意义。结论:依折麦布联合常规剂量他汀可安全用于PCI术后的调脂治疗,且疗效优于单用他汀,但未进一步降低PCI术后12周内MACE发生率。
Objective: To observe the efficacy and safety of statin alone and statin combined with ezetimibe in the regulation of lipid metabolism and short-term prognosis in patients after percutaneous coronary intervention (PCI). Methods: Ninety patients with chronic stable angina pectoris undergoing elective PCI in our hospital were randomly divided into 3 groups: simvastatin 40 mg / d (SI group, 30 cases), simvastatin 20 mg / day + ezetimibe 10 mg / d (SI / EZ group, 30 cases) and atorvastatin 20 mg / d (AT group, 30 cases) were followed up for 12 weeks. The main endpoint observed lipid-lowering efficacy and adverse drug reactions and LDL-C compliance rate, the secondary end point to observe the three groups of patients within 12 weeks after PCI major adverse cardiovascular events (MACE) incidence. Results: ① All the three lipid-lowering regimens could significantly reduce the level of LDL-C, TC, TG and high-sensitivity C-reactive protein, and raise the level of HDL-C at the same time. There was no significant difference between the three groups in the LDL-C compliance rate significance. At 12 weeks, the decrease of LDL-C (32.2%) and the decrease of TG (29.5%) in the combined treatment group (SI / EZ group) were higher than those in the two monotherapy groups (SI group and AT group) 0.05). ② There was no clinical significance of liver enzymes and muscle enzymes in group 3, and the incidence of common adverse reactions in combination therapy group was lower. There was no significant difference in the incidence of MACE between the three groups within 12 weeks after PCI. Conclusion: The combination of ezetimibe and conventional dose of statin can be safely used in the treatment of lipid-lowering therapy after PCI, and its efficacy is better than that of statin alone. However, the incidence of MACE within 12 weeks after PCI is not reduced further.