| 刘立新,田国祥,武云涛,等.匹伐他汀联合依折麦布或多廿烷醇治疗老年心血管疾病的效果对比[J].中国临床保健杂志,2021,24(3):328-332. |
| 匹伐他汀联合依折麦布或多廿烷醇治疗老年心血管疾病的效果对比 |
| Observation on efficacy of pitavastatin combined with policosanol or ezetimibe in the treatment of elderly patients with atherosclerotic cardiovascular disease |
| 投稿时间：2020-10-12 |
| DOI：10.3969/J.issn.1672-6790.2021.03.009 |
| 中文关键词: 心血管疾病 动脉粥样硬化 血脂异常 降血脂药物 老年人 |
| 英文关键词: Cardiovascular diseases Atherosclerosis Dyslipidemias Hypolipidemic agents Aged 〖FL |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨匹伐他汀联合依折麦布或多廿烷醇治疗老年心血管病的临床疗效。方法 选择服用匹伐他汀治疗血脂不达标的老年动脉粥样硬化性心血管病患者96例,按照随机数字表法分为依折麦布组(匹伐他汀2 mg/d联合依折麦布10 mg/d)和多廿烷醇组(匹伐他汀2 mg/d联合多廿烷醇10 mg/d),每组各48例。两组分别于治疗前及治疗4与12周检测三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白(a)、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酸激酶,同时记录临床疗效及不良反应。结果 两组降脂总有效率差异无统计学意义(P＞0.05),依折麦布组显效率明显优于多廿烷醇组(89.6%,68.8%,P=0.012)。治疗4、12周后,依折麦布组TC、TG、LDL-C、ApoB水平较治疗前显著降低(P＜0.05)；多廿烷醇组TC、LDL-C、ApoB水平较治疗前显著降低(P＜0.05)。治疗4、12周后,依折麦布组LDL-C水平均已达标且显著低于多廿烷醇组[4周:(1.65±0.33)mmol/L,(2.28±0.48)mmol/L,P＜0.05；12周:(1.45±0.39)mmol/L,(2.09±0.45)mmol/L,P＜0.05],而TC、TG、ApoB水平也显著低于多廿烷醇组(P＜0.05)。两组不良反应轻微,均未出现提前停药。结论 依折麦布或多廿烷醇与匹伐他汀联用治疗老年患者,均能有效降低血脂水平,且安全性、耐受性良好；但依折麦布联用匹伐他汀降脂效果及达标率明显更高。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy and safety of pitavastatin combined with ezetimibe or policosanol in the elderly patients with atherosclerotic cardiovascular disease.Methods Ninety-six elderly patients with atherosclerotic cardiovascular disease (ASCVD),who didn′t achieved guideline-recommended LDL-C target with pitavastatin-treated before,were assigned randomly to two groups.Patients in policosanol group (n=48) were treated with policosanol (10 mg per day) and pitavastatin (2 mg per day),those in ezetimibe group (n=48) were treated with ezetimibe (10 mg per day) and pitavastatin (2 mg per day).Their serum levels of TC,TG,LDL-C,HDL-C,ApoA,ApoB,Lp(a),ALT,AST and CK were measured before and at 4,12 weeks after treatment.Meanwhile,the therapeutic efficacy and adverse reactions were also observed.Results After the treatment,there was no significant difference in the total effective rate of lipid-lowering therapy between two groups (P＞0.05),but the excellent rate was significant higher in the ezetimibe group than that in the polyoxanol (89.6% vs.68.8%,P=0.012).The serum levels of TC,TG,LDL-C,ApoB were significantly lower in ezetimibe group at 4,12 weeks after treatment than before (P＜0.05),while the serum levels of TC,LDL-C,ApoB were significantly lower in polyoxanol group at 4,12 weeks than before (P＜0.05).LDL-C level was significantly lower at 4,12 weeks in ezetimibe group than in the policosanol group [4 weeks:(1.65±0.33)mmol/L vs.(2.28±0.48)mmol/L,P＜0.05;12 weeks:(1.45±0.39)mmol/L vs.(2.09±0.45)mmol/L,P＜0.05],and the LDL-C target level ＜1.8mmol/L was achieved in ezetimibe group.The effects of ezetimibe were significantly better than those of policosanol on TG,TC,ApoB at 4,12 weeks after treatment (P＜0.05).The adverse reactions were mild,no patients discontinued for safety or efficacy reasons in two groups.Conclusion Ezetimibe or Policosanol combined with pitavastatin can further improve lipid parameters,and has a good tolerability and safety in elderly patients.Ezetimibe plus pitavastatin appears to be more effective in lipid-lowering potency and achieving target LDL-C levels. |
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