[他汀类药物与苯扎贝特联合治疗对合并血脂异常的急性冠脉综合征患者的调脂作用及安全性]

[The lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome patients complicating with dyslipidemia].

作者信息

Li Xiang-ping, Gong Hai-rong, Zhao Shui-ping, Huang Wen-yu

机构信息

Second Hospital of Xiangya, Central South University, Changsha 410011, China.

Second Hospital of Xiangya, Central South University, Changsha 410011, China. Email:

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Dec;41(12):1006-9.

PMID:24524601

Abstract

OBJECTIVE

To investigate the lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome(ACS) patients complicating with dyslipedemia.

METHODS

One hundred and four hospitalized patients with established ACS and increased serum triglycerides (TG) levels and/or low serum levels of high density lipoprotein cholesterol (HDL-C) were selected. Except for conventional therapy, the patients were randomly divided into 2 groups: control group (n = 52), treated with atorvastatin 20 mg qn or other statin equivalent to 20 mg atorvastatin; treatment group (n = 52), treated with the same dose statin plus bezafibrate 200 mg bid. The serum levels of total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C) and HDL-C were assessed before and after 6 and 12 weeks treatment, side effects and adverse events were recorded.

RESULTS

After 6 weeks treatment, the serum levels of TC, TG and LDL-C in two groups were significantly reduced compared to baseline (all P < 0.05), which were further declined after 12 weeks treatment, and the reduction was more significant in treatment group(29.8%, 38.0% and 36.1%, respectively) than in control group(14.7%, 9.8% and 26.7%, respectively) (all P < 0.05). After treatment, the serum levels of HDL-C in the two groups were significantly higher than the baseline levels, especially after 12 weeks treatment (all P < 0.05), and the elevations of HDL-C levels in control group and in treatment group were 19.3% and 24.2%, respectively, but there were no significant difference between the two groups (P > 0.05). After 12 weeks, the rates reaching to target goals of LDL-C, TG, HDL-C, and non-HDL-C levels in the treatment group (69.2%, 88.5%, 92.3%, 46.2% and 65.4%, respectively) were significantly higher than those in the control group (34.6%, 65.4%, 46.2%, 7.7% and 42.3%, respectively, all P < 0.05). No serious side effects were observed in the two groups during the treatment period.

CONCLUSION

The combined statin and bezafibrate treatment is safe and could increase the ratios of reaching target lipid levels in ACS patients complicating with increased TG and (or) decreased HDL-C.

摘要

目的

探讨他汀类药物与苯扎贝特联合治疗对合并血脂异常的急性冠状动脉综合征（ACS）患者的调脂作用及安全性。

方法

选取104例确诊为ACS且血清甘油三酯（TG）水平升高和/或高密度脂蛋白胆固醇（HDL-C）水平降低的住院患者。除常规治疗外，将患者随机分为2组：对照组（n = 52），每晚服用阿托伐他汀20 mg或其他等效于20 mg阿托伐他汀的他汀类药物；治疗组（n = 52），服用相同剂量的他汀类药物加苯扎贝特200 mg，每日2次。在治疗前、治疗6周和12周后评估血清总胆固醇（TC）、TG、低密度脂蛋白胆固醇（LDL-C）和HDL-C水平，记录副作用和不良事件。

结果

治疗6周后，两组患者的血清TC、TG和LDL-C水平均较基线显著降低（均P < 0.05），治疗12周后进一步下降，且治疗组的降低幅度（分别为29.8%、38.0%和36.1%）大于对照组（分别为14.7%、9.8%和26.7%）（均P < 0.05）。治疗后，两组患者的血清HDL-C水平均显著高于基线水平，尤其是治疗第12周后（均P < 0.05），对照组和治疗组HDL-C水平的升高幅度分别为19.3%和24.2%，但两组间差异无统计学意义（P > 0.05）。12周后，治疗组达到LDL-C、TG、HDL-C和非HDL-C水平目标值的比例（分别为69.2%、88.5%、92.3%、46.2%和65.4%）显著高于对照组（分别为34.6%、65.4%、46.2%、7.7%和42.3%，均P < 0.05）。治疗期间两组均未观察到严重副作用。