Dagli Necati, Yavuzkir Mustafa, Karaca Ilgin
Departments of Cardiology, Firat University, School of Medicine, Elazig, Turkey.
Inflammation. 2007 Dec;30(6):230-5. doi: 10.1007/s10753-007-9041-3. Epub 2007 Aug 9.
Coronary artery disease (CAD) is presently the major cause of mortality and morbidity. Anti-hyperlipidemic treatment is one of the main treatment steps in the management of CAD. Statins are the cornerstones in this treatment. Ezetimibe can be reliably used, when statins prove ineffective in treatment, or to reduce their side effects. In the present study we examined the effects of high-dose pravastatin (40 mg) and low-dose pravastatin (10 mg) + ezetimibe (10 mg) combination therapy on lipid and glucose mechanism, as well as inflammation.
This study registered 100 cases. Of the cases, 50 [57.1 +/- 11.1 years (24 (48%) females and 26 (52%) males)] were administered 40 mg/day pravastatin (group 1) and 50 [53.2 +/- 12.2 years (27 (54%) females and 23 (46%) males)] were administered 10 mg pravastatin + 10 mg ezetimibe (group 2).
In group 1, total cholesterol fell from 231.1 +/- 83.5 mg/dl to 211.3 +/- 37.2 mg/dl (p = 0.03), triglyceride from 243.5 +/- 96.8 mg/dl to 190.9 +/- 55.2 mg/dl (p = 0.003), and LDL cholesterol from 165.7 +/- 29.7 mg/dl to 133.4 +/- 26.6 mg/dl (p = 0.02). In group 2, total cholesterol dropped from 250.9 +/- 51.8 mg/dl to 187.9 +/- 34.9 mg/dl (p = 0.001), triglyceride from 270.3 +/- 158.9 mg/dl to 154.6 +/- 60.7 mg/dl (p = 0.001), and LDL cholesterol from 158.1 +/- 47.5 mg/dl to 116.9 +/- 26.4 mg/dl (p = 0.001). Insulin resistance decreased from 4.05 +/- 2.31 to 3.16 +/- 1.90 (p = 0.07) in group 1 and from 2.96 +/- 1.50 to 2.05 +/- 0.55 (p = 0.009) in group 2. High sensitive C-reactive protein fell from 6.69 +/- 6.11 mg/l to 3.02 +/- 1.70 mg/l (p = 0.01) in group 1 and from 6.36 +/- 2.06 mg/l to 2.68 +/- 1.69 mg/l (p = 0.001) in group 2.
Both therapy regimes are effective. However, we found that low-dose pravastatin and ezetimibe combination therapy is more effective than high-dose pravastatin therapy on lipid metabolism, glucose metabolism and inflammation.
冠状动脉疾病（CAD）目前是死亡率和发病率的主要原因。抗高脂血症治疗是CAD管理中的主要治疗步骤之一。他汀类药物是该治疗的基石。当他汀类药物治疗无效或为减少其副作用时，依折麦布可可靠使用。在本研究中，我们研究了高剂量普伐他汀（40毫克）和低剂量普伐他汀（10毫克）+依折麦布（10毫克）联合治疗对脂质和葡萄糖代谢机制以及炎症的影响。
本研究登记了100例病例。其中，50例[年龄57.1±11.1岁（24例（48%）为女性，26例（52%）为男性）]给予每日40毫克普伐他汀（第1组），50例[年龄53.2±12.2岁（27例（54%）为女性，23例（46%）为男性）]给予10毫克普伐他汀+10毫克依折麦布（第2组）。
在第1组中，总胆固醇从231.1±83.5毫克/分升降至211.3±37.2毫克/分升（p = 0.03），甘油三酯从243.5±96.8毫克/分升降至190.9±55.2毫克/分升（p = 0.003），低密度脂蛋白胆固醇从165.7±29.7毫克/分升降至133.4±26.6毫克/分升（p = 0.02）。在第2组中，总胆固醇从250.9±51.8毫克/分升降至187.9±34.9毫克/分升（p = 0.001），甘油三酯从270.3±158.9毫克/分升降至154.6±60.7毫克/分升（p = 0.001），低密度脂蛋白胆固醇从158.1±47.5毫克/分升降至116.9±26.4毫克/分升（p = 0.001）。第1组胰岛素抵抗从4.05±2.31降至3.16±1.90（p = 0.07），第2组从2.96±1.50降至2.05±0.55（p = 0.009）。第1组高敏C反应蛋白从6.69±6.11毫克/升降至3.02±1.70毫克/升（p = 0.01），第2组从6.36±2.06毫克/升降至2.68±1.69毫克/升（p = 0.001）。
两种治疗方案均有效。然而，我们发现低剂量普伐他汀和依折麦布联合治疗在脂质代谢、葡萄糖代谢和炎症方面比高剂量普伐他汀治疗更有效。
