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阿托伐他汀单药治疗与小剂量阿托伐他汀/依折麦布联合治疗对混合型高脂血症患者空腹和餐后甘油三酯的影响。

Effect of atorvastatin monotherapy and low-dose atorvastatin/ezetimibe combination on fasting and postprandial triglycerides in combined hyperlipedemia.

机构信息

Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

J Cardiovasc Pharmacol Ther. 2012 Mar;17(1):65-71. doi: 10.1177/1074248411399762. Epub 2011 Mar 8.

Abstract

Postprandial triglyceride (TG) levels are easy to measure and are associated with future cardiovascular risk. The aim of this study was to compare the effects of statin monotherapy and low-dose statin/ezetimibe on lipid parameters including fasting and postprandial TG. After a 4-week dietary run-in period, 78 patients with combined hyperlipidemia were randomized into 1 of 2 treatment groups for 8 weeks: atorvastatin 20 mg or atorvastatin/ezetimibe 5 mg/5 mg. An oral fat load test was performed before and after the drug-treatment period. The low-dose combination had a tendency to decrease fasting TG more than atorvastatin monotherapy. The combination regimen showed a greater reduction in postprandial TG (-13% ± 42% and -34% ± 30%, in the atorvastatin and combination groups, respectively, P = .03) and total cholesterol (TC; P = .03). The changes in low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) were not different between the 2 groups. The reduction in apo B/A1 was greater in the combination group (-32% ± 19% and -42% ± 13%, in the atorvastatin and combination groups, respectively, P = .02). In conclusion, these results demonstrated a potential beneficial effect of low-dose atorvastatin/ezetimibe combination treatment on postprandial TG control after comparable LDL-C lowering in patients with combined hyperlipidemia.

摘要

餐后甘油三酯(TG)水平易于测量,与未来的心血管风险相关。本研究旨在比较他汀类药物单药治疗与低剂量他汀类药物/依折麦布对包括空腹和餐后 TG 在内的血脂参数的影响。在 4 周的饮食适应期后,78 例混合性高脂血症患者被随机分为 2 组,分别接受 8 周的治疗:阿托伐他汀 20 mg 或阿托伐他汀/依折麦布 5 mg/5 mg。在药物治疗前后进行口服脂肪负荷试验。与阿托伐他汀单药治疗相比,低剂量联合治疗有降低空腹 TG 的趋势。联合治疗方案显示餐后 TG 降低更明显(-13%±42%和-34%±30%,分别在阿托伐他汀和联合治疗组,P=0.03)和总胆固醇(TC;P=0.03)。两组间低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的变化无差异。载脂蛋白 B/A1 的降低在联合组更为明显(-32%±19%和-42%±13%,分别在阿托伐他汀和联合治疗组,P=0.02)。综上所述,这些结果表明,在联合性高脂血症患者 LDL-C 降低相当的情况下,低剂量阿托伐他汀/依折麦布联合治疗可能对餐后 TG 控制具有潜在的有益作用。

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