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目的:观察依折麦布联合辛伐他汀对单独应用辛伐他汀未能使总胆固醇(TC)达标的心肌梗死患者或心绞痛合并糖尿病患者血脂的影响,并对其安全性进行评价。方法:经辛伐他汀(40mg/d)治疗4周后TC未达标(>3.5mmol/L)的心肌梗死患者或心绞痛合并糖尿病患者47例,在应用辛伐他汀的基础上联合应用依折麦布(10mg/d)继续治疗4周,观察治疗后的血脂水平及药物对丙氨酸氨基转移酶(ALT)及肌酸激酶(CK)的影响。结果:联用依折麦布前后46例患者的TC分别为(4.01±0.50)mmol/L和(2.97±0.38)mmol/L(P<0.01),低密度脂蛋白胆固醇(LDL-C)分别为(2.42±0.41)mmol/L和(1.53±0.45)mmol/L(P<0.01),联用依折麦布前后高密度脂蛋白胆固醇(HDL-C)无显著变化(P=0.605),ALT及CK也无显著变化(P=0.057,P=0.738)。结论:依折麦布联合辛伐他汀可以达到冠心病患者强化降脂的作用,使TC、LDL-C较单独应用辛伐他汀进一步降低,且无肝脏及肌肉损伤。
AIM: To observe the effects of ezetimibe and simvastatin on the blood lipids in patients with myocardial infarction or angina pectoris complicated with diabetes mellitus (DM) without simvastatin alone and to evaluate the safety of ezetimibe and simvastatin. Methods: Forty-seven patients with myocardial infarction or angina pectoris with diabetes mellitus who were not up to standard (> 3.5mmol / L) after simvastatin (40mg / d) treatment for 4 weeks were enrolled in this study. Cloth (10mg / d) for 4 weeks, after treatment to observe the level of blood lipids and drugs on alanine aminotransferase (ALT) and creatine kinase (CK). Results: The TCs of 46 patients before and after ezetimibe were (4.01 ± 0.50) mmol / L and (2.97 ± 0.38) mmol / L respectively (P <0.01) and LDL-C (2.42 ± 0.41) mmol / L and (1.53 ± 0.45) mmol / L, respectively (P <0.01). There was no significant change in high density lipoprotein cholesterol (HDL-C) ALT and CK also did not change significantly (P = 0.057, P = 0.738). Conclusion: Ezetimibe combined with simvastatin can enhance lipid-lowering effect in patients with coronary heart disease, so that TC, LDL-C compared with the application of simvastatin alone further reduced, and no liver and muscle damage.