依折麦布联合阿托伐他汀治疗老年冠心病患者的降脂疗效

目的：观察联合应用依折麦布和阿托伐他汀对老年冠心病患者血脂水平的影响。方法：选择常规应用阿托伐他汀钙片20mg／d但血脂仍未达标的，符合入选标准的老年冠心病患者176例，随机分成两组，对照组为高剂量他汀组：阿托伐他汀钙片40mg／d；试药组为联合用药组：依折麦布10mg／d联合阿托伐他汀钙片20mg／d；比较两组治疗前后血总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）水平变化。结果：经12周治疗后，两组TC、LDI。一C与治疗前比较均有显著降低（均P〈0．05，P〈0．01）；与高剂量他汀组相比，联合用药组治疗效果更显著（P〈0．05），TC、LDL—C下降更明显（P〈0．05）；而肝损害及肌溶解等副作用的发生率却无明显增加。结论：与高剂量阿托伐他汀相比，依折麦布联合阿托伐他汀具有更好的降低LDL—C效果，显著提高冠心病患者的血脂达标率，且具有良好的安全性和药物耐受性。

Effect of combination of ezetimibe erly patients with coronary artery and atorvastatin on serum lipid in elddisease

AIM ： To observe the effect of combination of ezetimibe and atorvastatin on the serum lipid of elderly patients with coronary heart disease. METHODS： One hundred and seventy-six elderly patients with coronary artery disease whose serum lipid level did not meet normal criteria after taking atorvastatin 20 mg/d were assigned randomly to two groups. Patients in high-dose atorvastatin group were treated with atorvastatin 40 mg/d and patients in combination group were treated with ezetimibe 10 mg/d and low-dose atorvastatin 20 mg/d. The changes of serum lipid and side effects were compared between the two groups. RESULTS ： Total cholesterol （TC） and low density lipoprotein-cholesterol （ LDL-C ） decreased significantly in both groups after the 12-week therapy （ P 〈 0.05 ）. Compared with those in high-dose atorvastatin group, serum TC and LDL-C decreased markedly （ P 〈 0. 05 ） and serum lipid control rate was much higher in combination group. However, the rate of hepatic damage in combination group was much lower than that in high-dose atorvastatin group. CONCLUSION： Compared with high-dose atorvastatin, combination of ezetimibe and low-dose atorvastatin, safe and well-tolerated, can more significantly decrease TC and LDL-C and improve serum lipid control rate.