辛伐他丁与吉非罗齐治疗混合性高脂血症的疗效观察

目的：探讨辛伐他丁与吉非罗齐联合治疗混合性高脂血症的临床疗效及安全性。方法：110例混合性高脂血症患者，随机分为辛伐他丁组（n=33，20mg／d）、吉非罗齐组（n=32，900mg／d）和联合治疗组（n=35，辛伐他丁10mg／d和吉非罗齐450mg／d）疗程均为6月。观察治疗前后主要血脂指标的变化、迭标率以及不良反应。结果：联合治疗组血脂变化最显著，血清总胆固醇（TC），低密度脂蛋白（LDL-C）和甘油三酯（TG）均下降，而血清高密度脂蛋白胆固醇（HDL-C）升高（P均〈0．01）。脂异常防治建议的目标，联合治疗组TC、LDL-C、TG的迭标率分别为51．4％、48．6％、57．1％，三项指标全部迭标者为46．7％，明显高于单药治疗组（P〈0．01）。联合治疗组不良反应发生率和单药治疗组相比差异无统计学意义（P均〉0．05）。结论：本文提示小剂量辛伐他丁与吉非罗齐联合可以更全面地改善混合性高脂血症，较单药治疗更为有效，具有良好的安全性和耐受性。

Efficacy and safety combination therapy with simvastatin and gemfibrozil for combined hyperlipidemia

Objective:To evaluate the efficacy and safety of combination therapy with simvastatin and gemfibrozil in patients with combine hyperlipidemia.Methods:110 patients with combined hyperlipidemia were randomly assigned to receive 20mg simvastatin(n=33)or 900mg gemfibrozil(n=32)or a combination of 10mg simvastatin+450mg gemfibrozil(n=35)for 6 months.Lipid index and side effects were assessed.Results:Combination treatment more effective in normalizing lipid than any monotherapy.Serum TC,LDL-C,and TG were reduce,While HDL-C significantly increased(all P<0.01).The successful rate of LDL-C,TC,and TG control in the combination therapy group were 41%,49%,and 57% respectively,with overall success rate(all three together)of 46%,which was superior to either drug given as monotherapy(all P<0.01).All treatment were well tolerated with no increase in side effects for combination therapy versus monotherapy.Conclusions:The results of this study demonstrated that combination therapy with low-dose simvastatin(10mg/d)and gemfibrozil(450mg/d)is more effective than monotherapy in patients with combined hyperlipidemia,and is generally safe and well toleraled.