瑞舒伐他汀联合依折麦布治疗急性冠脉综合征合并糖尿病80例的疗效
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摘要
目的探讨瑞舒伐他汀联合依折麦布对急性冠脉综合征(ACS)合并2型糖尿病患者的近期疗效。方法选择2015年9月-2016年10月在宁夏第五人民医院收住的80例ACS合并2型糖尿病患者,随机分为对照组和联合治疗组,每组40例,对照组患者给予口服大剂量瑞舒伐他汀,联合治疗组在对照组治疗基础上口服依折麦布,随访6个月观察疗效、主要不良反应和不良心血管事件的发生情况。结果联合治疗组的总有效率(92.50%)高于对照组(χ~2=5.526,P<0.05);与治疗前比较,两组患者治疗后血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)和超敏C反应蛋白(hs-CRP)均下降(P均<0.05),高密度脂蛋白(HDL-C)两组治疗前后比较差异均无统计学意义(P>0.05);治疗后,联合治疗组患者血清TG、LDL-C、TC、hs-CRP水平低于对照组(P均<0.05);治疗期间,联合治疗组再发心绞痛率低于对照组(χ~2=3.914,P<0.05);治疗期间,对照组再次血管重建率高于联合治疗组(χ~2=4.013,P<0.05),两组不良反应发生率差异无统计学意义(P>0.05)。结论瑞舒伐他汀联合依折麦布可改善ACS合并2型糖尿病患者血脂水平,降低近期不良心血管事件的发生。
Objective To study the short-term and long-term effects of rosuvastatin combined with ezetimibe in the treatment of acute coronary syndrome(ACS)complicated with type 2 diabetes mellitus. Methods Total80 ACS patients with diabetes mellitus admitted to our hospital from September 2015 to October 2016 were randomly divided into control group and combination therapy group,with 40 cases in each group. All patients underwent coronary stent implantation and routine drug treatment. Patients in the control group were given oral rosuvastatin. Patients in the combined treatment group took ezetimibe orally on the basis of the control group.The curative effect,main adverse reactions and adverse cardiovascular events were observed after 6 months of follow-up. Results The total effective rate of the combined treatment group(92.50%)was higher than that of the control group(χ~2=5.526,P<0.05). Compared with before treatment,serum TC,LDL-C,TG and hs-CRP decreased in both groups(P<0.05). There was no significant difference in HDL-C between the two groups(P>0.05). After treatment,the serum levels of TG,LDL-C,TC and hs-CRP in the combination group were lower than those in the control group(P>0.05). The angina pectoris rate in combined treatment group was lower than that of the control group(χ~2=3.914,P<0.05). During the treatment period,the revascularization rate of the control group was higher than that of the combination group(χ~2=4.013,P<0.05). Conclusion Rosuvastatin combined with ezetimibe can improve the lipid levels of ACS patients with diabetes and reduce the incidence of recent adverse cardiovascular events.
Objective To study the short-term and long-term effects of rosuvastatin combined with ezetimibe in the treatment of acute coronary syndrome(ACS)complicated with type 2 diabetes mellitus. Methods Total80 ACS patients with diabetes mellitus admitted to our hospital from September 2015 to October 2016 were randomly divided into control group and combination therapy group,with 40 cases in each group. All patients underwent coronary stent implantation and routine drug treatment. Patients in the control group were given oral rosuvastatin. Patients in the combined treatment group took ezetimibe orally on the basis of the control group.The curative effect,main adverse reactions and adverse cardiovascular events were observed after 6 months of follow-up. Results The total effective rate of the combined treatment group(92.50%)was higher than that of the control group(χ~2=5.526,P<0.05). Compared with before treatment,serum TC,LDL-C,TG and hs-CRP decreased in both groups(P<0.05). There was no significant difference in HDL-C between the two groups(P>0.05). After treatment,the serum levels of TG,LDL-C,TC and hs-CRP in the combination group were lower than those in the control group(P>0.05). The angina pectoris rate in combined treatment group was lower than that of the control group(χ~2=3.914,P<0.05). During the treatment period,the revascularization rate of the control group was higher than that of the combination group(χ~2=4.013,P<0.05). Conclusion Rosuvastatin combined with ezetimibe can improve the lipid levels of ACS patients with diabetes and reduce the incidence of recent adverse cardiovascular events.
引文
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[8]方喜波,马怀英,李慧心,等.辛伐他汀联合依折麦布治疗急性冠脉综合征的疗效[J].心血管康复医学杂志,2015,24(1):65-68.
[9]李露露,张敏丽,张大庆.急性冠脉综合征合并2型糖尿病患者联合降脂的效果[J].中国医科大学学报,2013,42(11):985-988.
[10]郭艺芳. 2014年中国胆固醇教育计划血脂异常防治专家建议[J].中华心脏与心律电子杂志,2014,2(3):12-16.
[11]闫洪娟,王俊伟,郭建华,等.瑞舒伐他汀对高血压合并颈动脉硬化患者颈动脉斑块及脑缺血事件影响的前瞻性研究[J].中华全科医学,2017,15(8):1361-1364.
[12]蒋建东,赵祥海,陈燕春,等.短程大剂量瑞舒伐他汀对急性冠脉综合征患者血糖和血脂代谢的影响[J]. 2015,10:1197-1198.
[13]霍勇,葛均波,韩雅玲,等.急性冠状动脉综合征患者强化他汀治疗专家共识.中国介入心脏病学杂志,2014,22(1):4-6.
[14] Foody JM,Toth PP,Tomassini JE,et al. Changes in LDL-C levels and goal at tainment assoiated with addition of ezetimibe to simvastatin,atorvastatin,or rosuvastatin compared with titratingstatin monotherapy[J]. Vasc Health Risk Manag,2013,9:719-727.
[15]王华,陈婧,赵晓辉.阿托伐他汀联合依折麦布治疗急性冠脉综合征47例临床研究[J].中国药业,2014,23(12):46-48.
[2] Sweeny JM,Angiolillo DJ,Franchi F,et al. Impact of diabetes mellitus on the pharmacodynamic effects of ticagre-lor versus clopidogrel in troponin-negative acute coronary syndrome patients undergoing adhoc percutaneous coronary intervention[J]. J Am Heart Assoc,2017,6(4):e005650.
[3]朱立新,华红霞.大剂量瑞舒伐他汀对急性冠状动脉综合征疗效及安全性评估[J].实用临床医药杂志,2014,18(17):105-106.
[4]陈少萍.新型调脂药物依折麦布的临床应用[J].药学服务与研究,2014,14(4):1-2.
[5]朱毓文,林明琼.不同剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症的有效性及安全性[J].中国医院用药评价与分析,2016,16(9):1180-1182.
[6]李卫萍,顾复生,李虹伟.急性冠脉综合征合并2型糖尿病凝血功能与GRACE评分的相关性[J].山西医科大学学报,2015,46(9):841-84.
[7]李秀,王丹丹,王蔓蔓,等.不同剂量瑞舒伐他汀治疗急性冠脉综合征合并糖尿病患者的早期疗效及不良反应[J].实用医学杂志,2017,33(9):1486-1489.
[8]方喜波,马怀英,李慧心,等.辛伐他汀联合依折麦布治疗急性冠脉综合征的疗效[J].心血管康复医学杂志,2015,24(1):65-68.
[9]李露露,张敏丽,张大庆.急性冠脉综合征合并2型糖尿病患者联合降脂的效果[J].中国医科大学学报,2013,42(11):985-988.
[10]郭艺芳. 2014年中国胆固醇教育计划血脂异常防治专家建议[J].中华心脏与心律电子杂志,2014,2(3):12-16.
[11]闫洪娟,王俊伟,郭建华,等.瑞舒伐他汀对高血压合并颈动脉硬化患者颈动脉斑块及脑缺血事件影响的前瞻性研究[J].中华全科医学,2017,15(8):1361-1364.
[12]蒋建东,赵祥海,陈燕春,等.短程大剂量瑞舒伐他汀对急性冠脉综合征患者血糖和血脂代谢的影响[J]. 2015,10:1197-1198.
[13]霍勇,葛均波,韩雅玲,等.急性冠状动脉综合征患者强化他汀治疗专家共识.中国介入心脏病学杂志,2014,22(1):4-6.
[14] Foody JM,Toth PP,Tomassini JE,et al. Changes in LDL-C levels and goal at tainment assoiated with addition of ezetimibe to simvastatin,atorvastatin,or rosuvastatin compared with titratingstatin monotherapy[J]. Vasc Health Risk Manag,2013,9:719-727.
[15]王华,陈婧,赵晓辉.阿托伐他汀联合依折麦布治疗急性冠脉综合征47例临床研究[J].中国药业,2014,23(12):46-48.