不同调脂方案对冠心病患者尿酸水平的影响

目的:探探讨单用他汀治疗及联合治疗对血尿酸(SUA)的影响。方法:选取冠状动脉狭窄50%以上的冠心病患者76例,分为A组(阿托伐他汀20mg)36例和B组(阿托伐他汀20mg+依折麦布10mg)40例。在服药前,服药6周分别测定总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),甘油三酯(TG),高敏C反应蛋白(hs-CRP),尿酸(UA),肝肾功能,肌酸激酶(CK)。结果:(1)A组和B组均可以明显降低TC、LDL-C、TG和h8-CRP水平,同时提高HDL-C水平。6周时,A组的LDL-C水平为(1.96±0.62)mmol/L,较基线下降38.2%,B组的LDL-C是(1.51±0.92)mmol/L,较基线下降53.7%,两组之间差异有统计学意义(P<0.01)。(2)两组中,A组有1例出现谷草转氨酶升高,其余患者肝肾功能,肌酶均无明显升高。(3)两组在6周时SUA水平均较基线有明显下降(-10.9%vs.-11.2%,P>0.05),组间差异无统计学意义。结论:(1)联合治疗较单用他汀治疗能进一步改善血脂水平和hs-CRP水平,安全性良好。(2)阿托伐他汀20mg能显著降低患者SUA水平。

Effects of Different Statin Regiments on Lipid Profile and Serum Uric Acid in Patients with Coronary Heart Disease

Objective:To explore the effect of different statin regiments on lipid profile and serum uric in patients with coronary heart disease (CHD).Methods:Of 76 patients with CHD were randomly divided into group A(atorvastatin 20mg/d,N=36) and group B(atorvastain 20mg/d + ezetimibe 10mg/d,N=40).Lipid profile,high-sensitive C-reactive protein(hs-CRP),uric acid(SUA),liver-renal function,and creatine kinase(CK) were measured at baseline and at 6 weeks post-therapy.Results:(1)At 6-th week,lipid profile and hs-CRP were significantly improved in both groups.LDL-C reduction in group B was significantly greater than group A(-53.7%vs.-38.2%,P<0.01).(2) One patient,s AST≥3ULN at the end of study in group A,others Liver-renal function and CK remained unchanged significantly in both groups.(3) SUA was similarly reduced in both groups(-10.9%vs.-11.2%,respectively,P>0.05).Conclusions:Combined therapy is superior to atorvastatin 20mg monotherapy in reducing blood lipids and 20mg atorvastatin treatment significantly reduces SUA levels in patients with CHD.