阿托伐他汀联合非诺贝特治疗老年混合型高脂血症临床疗效观察

目的 探讨中等剂量阿托伐他汀片剂和非诺贝特胶囊联合应用治疗混合性高脂血症的临床疗效及安全性.方法 混合性高脂血症患者226例,随机分为：阿托伐他汀组112例,阿托伐他汀（20 mg/d）治疗;联合治疗组114例,阿托伐他汀（20 mg/d）和非诺贝特胶囊（200 mg/d）共治疗3个月.观察治疗前、后各项血脂参数的变化、达标率及不良反应.结果 除阿托伐他汀组高密度脂蛋白胆固醇（HDL-C）水平与治疗前相比无明显改善（0.99±0.27）mmol/L比（0.95±0.24）mmol/L,P＞0.05]外,两组患者各项血脂参数如血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）水平与治疗前相比均有不同程度的改善阿托伐他汀组：（4.22±0.46）mmol/L比（7.18±0.52）mmol/L,（2.76±0.34）mmol/L比（4.46±0.43）mmol/L,（3.05±0.44）mmol/L比（3.81±0.48）mmol/L;联合治疗组：（3.43±0.42）mmol/L比（7.15±0.50）mmol/L,（2.18±0.31）mmol/L比（4.44±0.42）mmol/L,（1.62±0.31）mmol/L比（3.85±0.51）mmol/L;P均＜0.05],但联合治疗组TG、TC、LDL-C降低的幅度和HDL-C升高幅度较大（3.05±0.44）mmol/L比（1.62±0.31）mmol/L,（4.22±0.46）mmol/L比（3.43±0.42）mmol/L,（2.76±0.34）mmol/L比（2.18±0.31）mmol/L,（1.23±0.30）mmol/L比（0.99±0.27）mmol/L,P均＜0.05],达标率更高（69.6%比13.4%,83.3%比71.4%,80.7%比67.9%,49.1%比9.8%,P均＜0.05）,明显优于阿托伐他汀组,两组患者不良反应的发生率相比差异无统计学意义（P＞0.05）.结论 中等剂量阿托伐他汀（20 mg/d）和非诺贝特胶囊（200 mg/d）联合应用对混合性高脂血症患者具有良好的安全性和有效性,值得临床推广应用.

Clinical efficacy of atorvastatin and fenofibrate in treatment of aged patients with combined hyperlipidemia familial

Objective To evaluate the clinical efficacy safety of the medium dosage of atorvastatin and fenofibrate in treatment of aged patients with combined hyperlipidemia familial. Methods A total of 226 patients with combined hyperlipidemia familial were randomly assigned to receive 20 mg/d atorvastatin （n= 112, group Ⅰ ） or a combination of 20 mg/d atorvastatin and 200 mg/d fenofibrate （n=114, group Ⅱ ） for 3 months. Lipidemic parameters, goal attainment rate and adverse events were assessed before and after treatment. Results Levels of HDL-C did not change obviously before and after atorvastatin taking （0.99±0.27）mmol/L vs （0.95±0.24）mmol/L P〉0.05]. Serum TC, LDL-C, TG were all reduced to some extent in both groups after medicine taking group Ⅰ ： （4.22±0.46）mmol/L vs （7.18±0.52）mmol/L, （2.76±0.34）mmol/L vs （4.46±0.43）mmol/L, （3.05±0.44） mmol/L vs （3.81±0.48）mmol/L,group Ⅱ ：（3.43±0.42）mmol/L vs （7.15±0.50）mmol/L,（2.18±0.31）mmol/L vs （4.44±0.42）mmol/L, （1.62±0.31）mmol/L vs （3.85±0.51）mmol/L. Every P of the above parameters was below 0.05]. Compared with group Ⅰ , group Ⅰ showed more improvement in TG, TC, LDL-C and HDL-C （3.05±0.44）mmol/L vs （0.62±0.31）retool/L, （4.22±0.46）mmol/L vs （3.43 ±0.42）mmol/L, （2.76±0.34）mmol/L vs （2.18±0.31）mmol/L, （1.23±0.30）mmol/L vs （0.99±0.27）mmol/L. Every P of the above parameters was below0.05]. The goal attainment rates of TG, TC, LDL-C and HDL-C in group 11 were also higher than those in group I （69.6% vs 13.4%, 83.3% vs 71.4%, 80.7% vs 67.9%, 49.1% vs 9.8%, all P〈0.05）. Moreover, the incidence rate of adverse events did not show statistical significance between both groups （P〉0.05）. Conclusion There results of this study demonstrate that the medium dosage of atorvastatin （20 mg/d） and fenofibrate （200 mg/d） shows satisfying safety and efficacy in aged patients with combined hyperlipidemia familial.