目的 探討依折麥布聯(lián)合阿托伐他汀治療高膽固醇血癥患者的效果及對(duì)血漿脂蛋白磷脂酶A2（Lp-PLA2）水平的影響。方法 選取東莞市第五人民醫(yī)院確診的高膽固醇血癥患者300例，病例收集時(shí)間2017年1月-2017年6月，采用隨機(jī)數(shù)字表法分為聯(lián)合組（阿托伐他汀20 mg/d+依折麥布10 mg/d）、他汀組（阿托伐他汀20 mg/d）各150例，連續(xù)治療3個(gè)月，檢測(cè)并對(duì)比兩組治療前后的血脂水平和Lp-PLA2。結(jié)果 治療前，聯(lián)合組和他汀組患者的血清總膽固醇（TC）、三酰甘油（TG）、高密度脂蛋白膽固醇（HDL-C）、低密度脂蛋白膽固醇（LDL-C）、Lp-PLA2水平差異均無統(tǒng)計(jì)學(xué)意義；兩組患者治療后的血清TC、TG、LDL-C、Lp-PLA水平較治療前均顯著的降低，HDL-C水平較治療前顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，聯(lián)合組患者的血清TC、TG、LDL-C、Lp-PLA2水平較他汀組顯著降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，聯(lián)合組患者顯效率為80.00%，總有效率為96.67%，他汀組顯效率為69.33%，總有效率為91.33%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。聯(lián)合組患者不良反應(yīng)發(fā)生率8.67%，與他汀組的6.00%比較，差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 依折麥布聯(lián)合阿托伐他汀治療高膽固醇血癥患者的效果優(yōu)于單純使用他汀類藥物治療，并且對(duì)血漿LpPLA2水平具有很好的改善作用。

Objective To investigate the effect of atorvastatin combined with ezetimibe on patients with hypercholesterolemia and the effect on plasma Lp-PLA2 levels. Methods 300 cases of hypercholesterolemia diagnosed by the Fifth People's Hospital of Dongguan City were selected. The case collection time was from January 2017 to June 2017. Randomized digital table method was divided into a combination group (atorvastatin 20 mg/d + ezetimibe 10 mg/d), statin group (atorvastatin 20 mg/d) 150 cases each, continuous treatment for 3 months to observe the two groups Clinical effects. Results There were no significant differences in serum TC, TG, HDL-C, LDL-C, and Lp-PLA2 levels between the combination group and the statin group before treatment. The levels of serum TC, TG, HDL-C, LDL-C and Lp-PLA in the two groups were significantly lower than those in the group before treatment. The difference between the two groups was statistically significant (P<0.05). After treatment, the serum levels of TC, TG, LDL-C, and Lp-PLA2 in the combination group were significantly lower than those in the statin group, and the difference was statistically significant (P<0.05). After treatment, the marked effective of combined group was 80%, total effective was 96.67%, and marked effect of statin group was 69.33%, total effective was 91.33%, the difference between the two groups was statistically significant (P<0.05). The incidence of adverse reactions in the combined group was 8.67%, which was not statistically significant compared with 6% in the statin group. Conclusion Atovastantin combined with ezetimibe is better than statins alone in the treatment of hypercholesterolemia, and has a good improvement in plasma Lp-PLA2 levels.

R969

東莞市社會(huì)科技發(fā)展一般項(xiàng)目（201650715001259）