【摘要】 目的探讨联合应用辛伐他汀和血脂康对急性冠脉综合征(ACS)患者血脂、血管内皮功能及炎症因子的影响,并评估其安全性。方法72例ACS患者平均分为辛伐他汀组(辛伐他汀20 mg.d-1)、血脂康组(血脂康1.2 g.d-1)、联合治疗组(辛伐他汀20 mg.d-1+血脂康1.2 g.d-1),疗程均为2个月。观察治疗前、治疗1个月、治疗2个月血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)的变化,同时观察血清内皮素(ET)、一氧化氮(NO)、C-反应蛋白(CRP)变化及药物不良反应。结果与治疗前相比,3组治疗1个月、2个月时TC、TG、LDL-C、CRP、ET水平均降低(P<0.05),血清NO水平增高(P<0.05),HDL-C水平有不同程度增高,其中血脂康组和联合治疗组在治疗1个月、2个月时HDL-C水平差异均有统计学意义(P<0.05),但辛伐他汀组HDL-C水平仅在治疗2个月时差异有统计学意义(P<0.05)。联合治疗组治疗1个月、2个月时血清TC、TG、LDL-C、CRP、ET水平较辛伐他汀组和血脂康组显著下降(P<0.05),血清HDL-C及NO水平增高(P<0.05)。与辛伐他汀组相比,治疗1个月、2个月时血脂康组TC、LDL-C、NO、CRP和ET水平差异无统计学意义(P>0.05),而TG显著降低(P<0.05),HDL-C明显增高(P<0.05)。结论联合辛伐他汀和血脂康治疗可以更全面地改善ACS患者的血脂异常,改善内皮功能和降低炎症因子的作用较单药治疗更有效。联合辛伐他汀和血脂康治疗具有良好的安全性和耐受性。更多还原

【Abstract】 Objective To explore the influences of therapeutic alliance of simvastatin and Xuezhikang(XZK) on serum lipids and vascular endothelial function and inflammatory factor in the patients of acute coronary syndrome(ACS),and to evaluate the safety of this therapy.Methods 72 patients of ACS were randomly divided into simvastatin group(20 mg.d-1 simvastatin,n = 22),XZK group(1.2 g.d-1 XZK,n = 24) and therapeutic alliance group(20 mg.d-1 simvastatin + 1.2 g.d-1 XZK,n = 26).The course of treatment were all 2 months.The changes of total cholesterol(TC)、Low-density lipoprotein-cholesterol(LDL-C),triglycerides(TG) and high-density lipoprotein-cholesterol(HDL-C) before treatment and 1 month and 2 months after treatment were observed,and so were the changes of endothelin(ET)、nitricoxide(NO)and C-reactive protein(CRP) and drug adverse reaction at the same time.Results The level of TC,TG,LDL-C and ET at the time of 1 month and 2 months after treatment were lower than those before treatment(P < 0.05),and the level of serum NO were higher(P < 0.05).The level of HDL-C at the time of 1 month and 2 months after treatment in XZK group and therapeutic alliance group were higher than those before treatment(P < 0.05),and the level of HDL-C at the time of 2 months in simvastatin group was higher than that before treatment(P < 0.05).The level of TC,TG,LDL-C,CRP and ET at the time of 1 month and 2 months after treatment in therapeutic alliance group were lower than those in simvastatin group and XZK group(P < 0.05),and the level of HDL-C and NO were significantly higher(P<0.05).There were no statistical significance in the level of TC,LDL-C,NO,CRP and ET at the time of 1 month and 2 months after treatment between XZK group and simvastatin group(P > 0.05),but the level of TG were significantly lower(P<0.05),the level of HDL-C were significantly higher(P<0.05).Conclusion The therapeutic alliance of simvastatin and XZK can improve the abnormality of blood fat in patients with ACS comprehensively,and the effects of improving the endothelial function and reducing the inflammation factors were more effective than that of single-agent therapy.This treatment is of great safety and tolerability.更多还原