联合应用阿托伐他汀和烟酸缓释片治疗混合性高脂血症的疗效及安全性观察

目的:探讨联合应用阿托伐他汀和烟酸缓释片治疗混合性高脂血症的临床疗效及安全性。方法:入选混合性高脂血症患者121例,随机分入阿托伐他汀组(10 mg／d,n=64)、联合治疗组(阿托伐他汀10 mg／d+烟酸缓释片500 mg／d,n=57),疗程3个月。观察治疗前后主要血脂参数的变化率、达标率以及不良反应。结果:①2组血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)水平均有不同程度的改善,但联合治疗组血脂参数的变化幅度更大,明显优于阿托伐他汀组(P均<0．01～0．05)。②联合治疗组TC、LDL-C和TG的达标率分别为75．44％、64．91％和61．40％,三项全部达标者占45．61％,明显高于阿托伐他汀组(P均<0．01)。③联合治疗组不良反应的发生率和阿托伐他汀组相比差异无统计学意义(P均>0．05)。结论:研究结果提示,烟酸缓释片(500 mg/d)与阿托伐他汀(10 mg／d)联合治疗可以更全面地改善混合性高脂血症患者的血脂异常,具有良好的安全性和耐受性。

Efficacy and Safety of Treatment for Mixed Hyperlipidemia With Atorvastatin and Extended-Release Nicotinic Acid

Objective: The aim of this study was to evaluate the efficacy and safety of treatement with atvastatin and extended-Release nicotinic in patients with mixed hyperlipidemia. Methods:A total of 121 patients with mixed hyperlipidemia were randomly assigned to receive 10 mg atorvastatin (n =64) or a combination of 10 mg atorvastatin + 500 mg slowreleased nicotinic acid (n = 57) for 3 months. Lipidemic paremeters, physical and laboratory investigations were assessed. Results: (1)Combination treatment was more effective in normalizing lipidemic paremeters than monotherapy. Serum TC, LDL-C, and TG were reduced by 52.56% , 54.35% and 51.28% respectively, while HDL-C was significantly increased by 37. 5% ( all P <0. 01). The improvement of TG or HDL-C achieved by combination treatment was superior to atorvastatin administration. (2)The standardized rates of TC, LDL-C and TG in the combination-therapy group amounted to 75. 44% , 64. 91% and 61. 40% respectively, with all the three reaching standards of 45. 61% , which were superior to the results of monotherapy. (3)All treatments were well tolerated. No increased adverse events were found for combination therapy versus monotherapy. Conclusion:The results of this study demonstrated that combination therapy with slowr eleased nicotinic acid (500 mg/d) and atorvastatin (10 mg/d) is more effective than monotherapy in patients with mixed hyperlipidemia, and that it is safe and well tolerated.