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时间:2020-04-25
《以非高密度脂蛋白胆固醇为靶标的联合降脂药物治疗急性冠脉综合征患者的疗效-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、岭南心血管病杂志2014年7月第20卷第4期·425·doi:10.3969/j.issn.1007—9688.2014.04.006·论著·以非高密度脂蛋白胆固醇为靶标的联合降脂药物治疗急性冠脉综合征患者的疗效△李晚泉,方长庚,涂军荣,梁建光,郑晓东(广东医学院附属三水医院佛山市三水区人民医院,广东佛山528100)摘要:目的以血清非高密度脂蛋白胆固醇(non.high.densitytipoproteincholesterol,non.HDL.C)浓度为靶标,探讨阿托伐他汀和非诺贝特联合用药在急性冠脉综合征患者中的疗效和安全性。方法选取200例急性冠脉综
2、合征患者,网络随机分为他汀降脂组(n=100,阿托伐他汀20mg/d)和联合降脂组(n=100。阿托伐他汀20mg/d+非诺贝特250mg/d),分别于治疗前及治疗后3个月、l2个月、24个月检测两组血清血脂浓度和高敏C反应蛋白(high-sensitivityCreactionprotein,hs—CRP)浓度,计算non-HDL—C变化率及达标率,并记录两组患者主要心血管事件发生情况。结果联合降脂组血脂和hs.CRP浓度降低幅度明显优于他汀降脂组;达标率、斑块消退率、血清C反应蛋白浓度<2mg/L率明显高于对照组,差异有统计学意义(P3、非致死性心肌梗死、再次血运重建、缺血性卒中、不稳定型心绞痛的事件发生上,联合降脂组明显优于他汀降脂组,差异有统计学意义(P<0.05)。但两组全因病死率、心脏性死亡事件发生率比较,差异无统计学意义(P>0.05)。结论对急性冠脉综合征患者予以阿托伐他汀联合非诺贝特的降脂治疗较单药治疗效果更显著,具有良好的耐受性和安全性。关键词:冠状动脉疾病;联合降脂;低密度脂蛋白胆固醇中图分类号:R541.4文献标志码:A文章编号:1007—9688(2014)04—0425—05Effectofcombinationlipid-loweringtherapyforpati4、entswithacutecoronarysyndrometargetingatnon-high-densitylipoproteincholesterolLIWan-quan,FANGChang—geng,TUJun—rong,LIANGJian-guang,ZHENGXiao—dong(SanshuiHospitalAffiliatedtoGuangdongMedicalUniversity,ThePeople’SHospitalofSanshui,Foshan,Guangdong528100.China)Abstract:ObjectivesToinv5、estigatetheeficacyandsafetyofcombinationlipid-loweringtherapywithatorvastatinandfenofibrateforpatientswithacutecoronarysyndrome(ACS)targetingatnon-high—densitylipoproteincholesterol(non—HDL—C).MethodsTotally200patientswithACSwererandomlydividedintotwogroups:singlemedicationgroup(n=6、100,atorvastatin20mg/d)andcombinationmedicationgroup(n=lO0,atorvastatin20mg/d+fenofibrate250mg/d).Beforetreatment,concentrationsofbloodlipidsandhigh—sensitivityC—reactionprotein(hs—CRP)wererecorded.Theywerere-examinedin3months,12monthsand24monthsaftertreatment.Changeandcompliancera7、teofnon—HDL-Candmajoradversecardiovasculareventswereassessed.ResultsCombinationtherapywasmuchmoreefectiveinnormalizinglipidprofileandhs—CRPconcentrationthansinglemedication(P<0.05).Compliancerate,plaqueregressionrateandC·reactionprotein<2mg/Lrateincombinationtherapygroupweremuchhig8、herthanthoseinsinglemedica
3、非致死性心肌梗死、再次血运重建、缺血性卒中、不稳定型心绞痛的事件发生上,联合降脂组明显优于他汀降脂组,差异有统计学意义(P<0.05)。但两组全因病死率、心脏性死亡事件发生率比较,差异无统计学意义(P>0.05)。结论对急性冠脉综合征患者予以阿托伐他汀联合非诺贝特的降脂治疗较单药治疗效果更显著,具有良好的耐受性和安全性。关键词:冠状动脉疾病;联合降脂;低密度脂蛋白胆固醇中图分类号:R541.4文献标志码:A文章编号:1007—9688(2014)04—0425—05Effectofcombinationlipid-loweringtherapyforpati
4、entswithacutecoronarysyndrometargetingatnon-high-densitylipoproteincholesterolLIWan-quan,FANGChang—geng,TUJun—rong,LIANGJian-guang,ZHENGXiao—dong(SanshuiHospitalAffiliatedtoGuangdongMedicalUniversity,ThePeople’SHospitalofSanshui,Foshan,Guangdong528100.China)Abstract:ObjectivesToinv
5、estigatetheeficacyandsafetyofcombinationlipid-loweringtherapywithatorvastatinandfenofibrateforpatientswithacutecoronarysyndrome(ACS)targetingatnon-high—densitylipoproteincholesterol(non—HDL—C).MethodsTotally200patientswithACSwererandomlydividedintotwogroups:singlemedicationgroup(n=
6、100,atorvastatin20mg/d)andcombinationmedicationgroup(n=lO0,atorvastatin20mg/d+fenofibrate250mg/d).Beforetreatment,concentrationsofbloodlipidsandhigh—sensitivityC—reactionprotein(hs—CRP)wererecorded.Theywerere-examinedin3months,12monthsand24monthsaftertreatment.Changeandcompliancera
7、teofnon—HDL-Candmajoradversecardiovasculareventswereassessed.ResultsCombinationtherapywasmuchmoreefectiveinnormalizinglipidprofileandhs—CRPconcentrationthansinglemedication(P<0.05).Compliancerate,plaqueregressionrateandC·reactionprotein<2mg/Lrateincombinationtherapygroupweremuchhig
8、herthanthoseinsinglemedica
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