瑞舒伐他汀剂量加倍和联合普罗布考治疗冠心病合并高胆固醇血症患者的疗效比较

目的比较瑞舒伐他汀剂量加倍与联用普罗布考对冠心病合并高胆固醇血症患者的疗效。方法在2012年1月至2013年12月在长海医院心内科就诊的冠心病患者中,选取经瑞舒伐他汀10mg、每晚1次治疗3个月以上,低密度脂蛋白胆固醇(LDL-C)仍不能达标者,将其随机分为他汀剂量加倍组(瑞舒伐他汀片20mg、每晚1次)和联合治疗组(瑞舒伐他汀片10mg、每晚1次+普罗布考片250mg、每天2次),每组各34例,治疗3个月。比较两组患者治疗前和治疗后外周血脂水平的变化以及不良反应发生率。结果治疗前两组患者一般情况、血脂水平差异无统计学意义(P>0.05)。治疗后3个月,两组患者总胆固醇(TC)、LDL-C均明显下降(P<0.05);联合治疗组三酰甘油(TG)明显下降(P<0.05);他汀加倍组、联合治疗组高密度脂蛋白胆固醇(HDL-C)分别显示升高和下降的趋势,但均未达到统计学差异(P>0.05)。与他汀加倍组相比,联合治疗组TC、LDL-C降得更低(P<0.05),LDL-C达标率更高(P<0.05),但HDL-C明显降低(P<0.05)。两组患者不良反应发生率比较,联合治疗组明显低于他汀加倍组(P<0.05)。结论对于冠心病合并高胆固醇血症患者,瑞舒伐他汀与普罗布考联合使用优于瑞舒伐他汀剂量加倍的疗效,且具有更高的安全性。

Doubled dose rosuvastatin or rosuvastatin combined with probucol for treatment of patients with coronary artery disease and hypercholesterolemia: a comparison of effectiveness

Objective To compare the effectiveness between doubled dose rosuvastatin and rosuvastatin combined with probucol for treatment of patients with coronary artery disease and hypercholesterolemia. Methods From Jan. 2012 to Dec. 2013, 68 patients with coronary heart disease, who were treated with rosuvastatin (10 mg qn) for more than 3 months in the Cardiology Clinic, Changhai Hospital and whose low density lipoprotein cholesterol (LDL-C) still not reached the target level, were evenly randomized into two groups: the double dose statin group (rosuvastatin 20 mg qn) and the combined treatment group (rosuvastatin 10 mg qn plus probucol 250 mg bid); the treatment lasted for 3 months. The peripheral blood lipid levels and incidence rates of adverse reactions were compared between the two groups. Results The baseline data and the lipid levels were not significantly different between the two groups before treatment (P>0.05). After 3 months of treatment, the total cholestrol (TC ) and LDL-C were significantly decreased in the two groups (P<0.05); triglyceride (TG) was significantly decreased only in the combined treatment group (P<0.05); the high-density lipoprotein cholesterol (HDL-C) had an increasing trend in the double rosuvastatin group and a decreasing one in the combined treatment group, but without statistical significance (P>0.05). Compared with the double rosuvastatin group, the combined treatment group had significantly greater decreases of TC and LDL-C (P<0.05), a significantly higher control rate of LDL-C (P<0.05), and a significantly lower HDL-C level (P<0.05). The combination treatment group had significantly less adverse reactions compared with the double rosuvastatin group (P<0.05). Conclusion For patients with coronary artery disease and hypercholesterolemia, it is more effective and safe to be treated with rosuvastatin combined with probucol than doubling the dose of rosuvastatin.