Duke Lipid Clinic, Department of Medicine, Box 3510, Duke University Medical Center, Durham, NC 27710, USA.
Diab Vasc Dis Res. 2011 Apr;8(2):160-72. doi: 10.1177/1479164111406457.
Treatment guidelines identify low-density lipoprotein cholesterol (LDL-C) as the primary target of therapy with secondary targets of non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (apoB). Data were pooled from 27 randomised, double-blind, active or placebo-controlled trials in 21,794 adult hypercholesterolaemic patients (LDL-C 1.81-6.48 mmol/L) receiving ezetimibe/statin or statin for 4-24 weeks. Percentages of patients achieving various targets were calculated among diabetes (n = 6541) and non-diabetes (n = 15,253) subgroups. Significantly more patients with and without diabetes achieved specified levels of LDL-C (< 2.59, < 1.99, < 1.81 mmol/L), non-HDL-C (< 3.37, < 2.59 mmol/L) and apoB (< 0.9, < 0.8 g/L) with ezetimibe/statin versus statin. Patients with diabetes had larger mean per cent reductions in LDL-C and non-HDL-C than non-diabetes patients. A greater percentage of patients achieved both the LDL-C and apoB targets and all three LDL-C, apoB, and non-HDL-C targets with ezetimibe/statin versus statin in both subgroups. Patients with diabetes benefitted at least as much as, and sometimes more than, non-diabetes patients following treatment with ezetimibe/statin.
治疗指南将低密度脂蛋白胆固醇（LDL-C）确定为治疗的主要目标，次要目标为非高密度脂蛋白胆固醇（non-HDL-C）和载脂蛋白 B（apoB）。这些数据来自 27 项随机、双盲、活性或安慰剂对照试验，共纳入 21794 例成人高胆固醇血症患者（LDL-C 为 1.81-6.48mmol/L），接受依折麦布/他汀类药物或他汀类药物治疗 4-24 周。在糖尿病（n=6541）和非糖尿病（n=15253）亚组中计算达到各种目标的患者百分比。与他汀类药物相比，接受依折麦布/他汀类药物治疗的患者中，无论是否患有糖尿病，达到特定 LDL-C（<2.59、<1.99、<1.81mmol/L）、non-HDL-C（<3.37、<2.59mmol/L）和 apoB（<0.9、<0.8g/L）水平的患者比例显著更高。患有糖尿病的患者比非糖尿病患者的 LDL-C 和 non-HDL-C 平均降低幅度更大。与他汀类药物相比，在两个亚组中，接受依折麦布/他汀类药物治疗的患者达到 LDL-C 和 apoB 双重目标的比例以及 LDL-C、apoB 和 non-HDL-C 三个目标的比例均更高。在接受依折麦布/他汀类药物治疗后，糖尿病患者的获益至少与非糖尿病患者相当，有时甚至更大。
