依折麦布联合瑞舒伐他汀对脑梗死患者血脂和高敏C反应蛋白及血管性血友病因子的作用

目的观察依折麦布联合瑞舒伐他汀对脑梗死患者的血脂、高敏C反应蛋白(hs-CRP)及血管性血友病因子(vWF)等指标的影响。方法前瞻性纳入急性脑梗死患者86例,随机分为10 mg他汀组(瑞舒伐他汀10 mg/d,30例),20 mg他汀组(瑞舒伐他汀20 mg/d,27例)和联合组(依折麦布10 mg/d,瑞舒伐他汀10 mg/d,29例),共给药治疗16周。比较治疗前后以及不同组别的血脂、hs-CRP、vWF、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)的变化。结果①与治疗前比较,治疗后各组低密度脂蛋白胆固醇(LDL-C)和胆固醇(TC)水平均降低,差异有统计学意义(P<0.01)。②治疗16周后,20 mg他汀组和联合组LDL-C、TC、hs-CRP和vWF水平均低于10 mg他汀组,差异均有统计学意义(P<0.01)。③治疗期间,三组均无因不良反应而停药病例。治疗16周后,ALT、AST、CK组间比较和治疗前后比较,差异均无统计学意义(P>0.05)。结论依折麦布联合瑞舒伐他汀比单用10 mg瑞舒伐他汀具有更好的降低LDL-C和TC的作用。

Effects of the combination of ezetimibe and rosuvastatin on blood-lipids and high sensitive C-reactive protein in patients with cerebral infarction

Objective To observe the effects of the combination of ezetimibe and rosuvastatin on blood-lipids,high sensitive C-reactive protein（hs-CRP） and von Willebrand factor（vWF） in patients with cerebral infarction.Methods A total 86 patients with acute cerebral infarction were enrolled prospectively.They were randomly assigned to a 10 mg statin group（rosuvastatin 10 mg/d,n=30）,a 20 mg statin group（rosuvastatin 20 mg/d,n=27） and a combined group（ezetimibe 10 mg/d,rosuvastatin 10 mg/d,n=29）.They were treated for 16 weeks.The changes of blood-lipids,hs-CRP,vWF,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,and creatine kinase（CK） were compared before and after treatment.Results ①Compared with before treatment,the levels of low-density lipoprotein（LDL-C） and cholesterol（TC） in all groups were deceased after treatment（P0.01）.②After 16 weeks of treatment,the levels of LDL-C,TC,hs-CRP and vWF in the 20 mg statin group and the combined group were lower than those in the 10 mg statin group.There were significant differences（P0.01）.③No patients withdrew because of adverse reaction among the three groups during the treatment.After 16 weeks of treatment,there were no significant differences in ALT,AST and CK among the groups before and after treatment（P0.05）.Conclusion The combination of ezetimibe and rosuvastatin is better than 10 mg rosuvastatin alone in lowering the effect of LDL-C and TC.