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依折麦布联合阿托伐他汀治疗2型糖尿病合并冠心病患者颈动脉斑块的疗效

Efficacy of ezetimibe combined with atorvastatin in the treatment of carotid artery plaque in patients with type 2 diabetes mellitus complicated with coronary heart disease.

作者信息

Wang Jing, Ai Xiao-Bo, Wang Fei, Zou Yao-Wu, Li Li, Yi Xiao-Lei

机构信息

Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Nephrology, Qingdao Fifth People's Hospital, Qingdao, China.

出版信息

Int Angiol. 2017 Oct;36(5):467-473. doi: 10.23736/S0392-9590.17.03818-4. Epub 2017 Jun 21.

Abstract

BACKGROUND

The aim of this study was to evaluate the efficacy of ezetimibe combined with atorvastatin in treatment of carotid artery plaque in patients with type 2 diabetes mellitus complicated with coronary heart disease (CHD).

METHODS

A total of 100 patients with carotid atherosclerosis (CAS) confirmed by ultrasound and diagnosed with type 2 diabetes mellitus and CHD were randomly assigned to atorvastatin group (atorvastatin 20 mg/day) or combined treatment group (ezetimibe 10 mg/day and atorvastatin 20 mg/day). All those patients were followed for 12 months. Serum lipid, ALT, AST, and CK were measured before and after treatment. Ultrasonography was used to evaluate the stability of carotid artery plaques.

RESULTS

After 12 months of treatment, the level of TC, TG, LDL-C, hs-CRP, FPG and HbA1c decreased in both groups compared with before treatment. TC, TG, LDL-C and hs-CRP in the combined treatment group were much lower than that in the atorvastatin group (P<0.05). The IMT and plaque area in the two groups were lower than that before the treatment (P<0.05). IMT and plaques area in the combined treatment group is much lower than that in the atorvastatin group after treatment. There was no significant difference in two groups on the level of ALT, AST, CK compared with baseline after treatment.

CONCLUSIONS

The effect of combined use of atorvastatin and ezetimibe was better than atorvastatin alone, which can effectively reduce the blood lipid levels in diabetic patients with CHD and improve plaque stability. Both treatment regimens were safe and well tolerated.

摘要

背景

本研究旨在评估依折麦布联合阿托伐他汀治疗2型糖尿病合并冠心病患者颈动脉斑块的疗效。

方法

选取100例经超声确诊为颈动脉粥样硬化(CAS)且诊断为2型糖尿病合并冠心病的患者,随机分为阿托伐他汀组(阿托伐他汀20mg/天)或联合治疗组(依折麦布10mg/天和阿托伐他汀20mg/天)。所有患者随访12个月。治疗前后检测血脂、谷丙转氨酶(ALT)、谷草转氨酶(AST)和肌酸激酶(CK)。采用超声评估颈动脉斑块的稳定性。

结果

治疗12个月后,两组患者的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、空腹血糖(FPG)和糖化血红蛋白(HbA1c)水平均较治疗前降低。联合治疗组的TC、TG、LDL-C和hs-CRP水平显著低于阿托伐他汀组(P<0.05)。两组患者的内膜中层厚度(IMT)和斑块面积均低于治疗前(P<0.05)。治疗后联合治疗组的IMT和斑块面积显著低于阿托伐他汀组。治疗后两组患者的ALT、AST、CK水平与基线相比无显著差异。

结论

阿托伐他汀与依折麦布联合使用的效果优于单用阿托伐他汀,可有效降低2型糖尿病合并冠心病患者的血脂水平,提高斑块稳定性。两种治疗方案均安全且耐受性良好。

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