阿托伐他汀联合阿昔莫司治疗混合性高脂血症的临床观察

目的：观察阿托伐他汀联合阿昔莫司治疗混合性高脂血症的疗效及安全性。方法：将150例混合性高脂血症患者随机均分为阿托伐他汀组、阿昔莫司组和联合治疗组（阿托伐他汀＋阿昔莫司）。阿托伐他汀组患者给予阿托伐他汀20mg，每晚1次；阿昔莫司组患者给予阿昔莫司250mg，每日早、晚各服1次；联合治疗组患者给予阿托伐他汀和阿昔莫司，用法、用量与阿托伐他汀组和阿昔莫司组相同。3组患者疗程均为8周。比较3组患者的临床疗效；检测治疗前后所有患者的总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）水平并计算达标率；观察所有患者治疗前后的肝肾功能、肌酐（Cr）、血清肌酐激酶（cK）、磷酸肌酸（Cry）的变化及不良反应发生情况。结果：联合治疗组患者总有效率均显著高于阿托伐他汀组和阿昔莫司组，两组比较差异有统计学意义（P〈0.05）。治疗后，3组患者TC、TG、LDL水平均显著低于同组治疗前，阿昔莫司组和联合治疗组患者HDL水平显著高于同组治疗前，治疗前、后比较，差异有统计学意义（P〈0．05）。联合治疗组患者TG、LDL均显著低于阿托伐他汀组和阿昔莫司组，且TC、TG、LDL、HDL达标率均显著高于阿托伐他汀组和阿昔莫司组，分别比较差异均有统计学意义（P〈0．05）。3组患者不良反应发生率比较，差异无统计学意义（P〉0．05）。结论：阿托伐他汀联合阿昔莫司治疗混合性高脂血症疗效显著．且安全性较好。

Clinical Observation of Atorvastatin Combined with Acipimox for Combined Hyperlipidemia

OBJECTIVE： To observe clinical efficacy of atorvastatin combined with acipimox for combined hyperlipidemia. METHODS： 150 cases of combined hyperlipidemia were randomly divided into atorvastatin group, acipimox group and combined treatment group （atorvastatin＋acipimox）. Atorvastatin group was given atorvastatin 20 mg orally every night; acipimox group received acipimox 250 mg orally every morning and night; combined treatment group was treated with atorvastatin and acipimox with the same usage and dosage of atorvastatin group and atorvastatin group. All patients in 3 groups were treated for 8 weeks. Clinical efficacies of all patients were evaluated. The changes of the main lipid parameters, such as TC, TG, LDL and HDL, were detected before and after treatment; the compliance rate was calculated. Hepatic function, renal function, serum creatinine kinase （CK）, creatine phosphate （CrP） and side effects were also observed and analyzed in this study. RESULTS： Total effective rate of combination group was significantly higher than the atorvastatin group and acipimox group （P〈0.05）. The levels of TC, TG and LDL in 3 groups were significantly lower than before; there was statistical significance （P〈0.05）. The HDL of acipimox group and combined treatment group was significantly higher than before, there was statistical significance （P〈0.05）. After treatment, the levels of TG and LDL in combined treatment group were significantly lower than in atorvastatin group and acipimox group; the compliance rates of TC, TG, LDL and HDL in combined treatment group were significantly higher than those of atorvastatin group and acipimox group; there was statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR among 3 groups （P〉0.05）. CONCLUSIONS： Atorvastation combined with acipimox is safe and effective for combined hyperlipidemia.