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目的观察依折麦布联合辛伐他汀对高脂血症合并动脉粥样硬化患者颈动脉内膜中层厚度(carotid arterial intima-media thickness,CIMT)的影响。方法采用随机、双盲研究,入选我院2013年6月至2014年8月门诊的高脂血症合并颈动脉粥样硬化患者,共108例,平均年龄67.4±9.3岁。将108例患者随机分为治疗组与对照组。所有患者均可正常饮食,继续原发病的常规治疗,停用其它降脂药物2周,以减少其它降脂药物对疗效判断的干扰,治疗组54例患者在辛伐他汀10 mg/d的基础上加用依折麦布5 mg/d,对照组54例患者使用辛伐他汀10 mg/d治疗4个月。均每日服药1次,于每晚入睡前或晚餐后3小时服用.4个月后以超声观察CIMT的变化,并采空腹静脉血,测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)。结果冶疗组与对照组的颈动脉内膜厚度及血脂水平均有明显下降,治疗组的颈动脉内膜中层厚度有下降更明显,从1.83±0.36mm下降至1.41±0.29mm,有统计学意义(p<0.01;且改善较对照组更明显(p<0.05),所有患者对依折麦布均能很好地耐受而且依从性较好,研究期间未发现药物相关严重不良反应。结论依折麦布联合辛伐他汀对高脂血症合并颈动脉粥样硬化的CIMT改善优于单用辛伐他汀组.并具有良好的安全性。
Objective To observe the effect of ezetimibe and simvastatin on carotid arterial intima-media thickness (CIMT) in patients with hyperlipidemia and atherosclerosis. Methods A randomized, double-blind study was enrolled in our hospital from June 2013 to August 2014 outpatient hyperlipidemia patients with carotid atherosclerosis, a total of 108 cases, with an average age of 67.4 ± 9.3 years. 108 patients were randomly divided into treatment group and control group. All patients can be normal diet, to continue the routine treatment of primary disease, disable other lipid-lowering drugs for 2 weeks to reduce the interference of other lipid-lowering drugs to determine the efficacy of the treatment group of 54 patients with simvastatin 10 mg / d Based on the use of ezetimibe 5 mg / d, the control group of 54 patients with simvastatin 10 mg / d for 4 months. All patients were taken once daily for 3 hours before falling asleep or 3 hours after dinner.After 4 months, the changes of CIMT were observed by ultrasonography and the fasting venous blood was collected for determination of total cholesterol (TC), low density lipoprotein cholesterol (LDL) -C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG). Results The carotid intima-media thickness and blood lipid level of the treatment group and the control group were significantly decreased, the carotid artery intima-media thickness of the treatment group decreased more significantly from 1.83 ± 0.36mm to 1.41 ± 0.29mm, with statistics (P <0.01), and the improvement was more obvious than the control group (p <0.05), all patients were well tolerated and treated with ezetimibe, and no drug-related adverse reactions were found during the study.Conclusions Ezetimibe combined with simvastatin on hyperlipemia with carotid atherosclerosis CIMT improvement over monotherapy with simvastatin group and has good safety.