辛伐他汀联合非诺贝特治疗混合型高脂血症的疗效和安全性探讨

目的评价辛伐他汀联合非诺贝特治疗混合型高脂血症的疗效和安全性。方法选择冠心病合并混合型高脂血症患者46例，治疗前2周停服调脂药，随机分为辛伐他汀±非诺贝特联合组（A组n=23）和辛伐他汀单药组（B组，n=23）两组。A组患者中男16例，女7例，年龄（60．01±8．25）岁，给予辛伐他汀20mg，每晚睡前口服，非诺贝特0．1g，每日2次，连续24周。B组患者中男15例，女8例，年龄（60．00±7．8）岁，给予辛伐他汀20mg，每晚睡前口服，连续24周，服药前和服药24周后各测定TC、TG、LDL-C、HDL-C、GPT、CK一次。结果治疗24周后，A组血清总胆固醇降低27．8％，TG下降56％，LDL—C下降41．4％，HDL-C升高22％。B组TC下降15．4％，TG下降11．6％，LDL-C下降24．7％，HDL—C上升11．5％（P〈0．05），24周内A组有3例发生不稳定性心绞痛，B组有6例发生不稳定性心绞痛（P〈0．05）。两组没有患者因为严重不良反应事件而退出。结论联合应用辛伐他汀和非诺贝特治疗混合型高脂血症与单药相比能更有效地降低高血脂水平，显著降低冠心病发病率，改善预后。

The efficacy and safety of simvastatin in combination with fenofibrate in treatment of combined hyerlipidemia

Objective To review the efficacy and safety of simvastatin in combination with fenofibrate in treatment of combined hyperlipidemia. Methods Forty-six cases of coronary heart disease with combined hyperlipidemia were randomized into two groups, 23 in each one. Group A included 16 men and 7 women, with a mean （SD） age of （60.01 ± 8.25） years; group B included 15 men and 8 women, with a mean age of （60.00± 7.8 ） years. Patients in group A took orally simvastatin at dose of 20mg at bedtime and fenofibrate 0. lg twice a day; and patients in group B were treated only with simvastatin at dose of 20mg at bedtime. Both regimens lasted for 24 weeks. Blood lipid measurements were planned before and after the study took place. Results Serum levels of total cholesterol （TC）, triglycerides （TG） and low density lipoprotein-cholesterol （LDL-C） were decreased respectively by 27.8%, 56% and 41.4% in group A; and by 15.4%, 11.6% and 24.7% in group B. On the contrary, high density lipoprotein cholesterol （HDL-C） was increased by 22% in group A and by 11.5% in group B （ P 〈0.05）. Three patients with unstable angina pectoris were found in group A, and six in group B （ P 〈 0.05）. Conclusion Simvastatin in combination with fenofibrate may provide a safe and efficacious treatment modality that enables achievement of several therapeutic goals in patients with combined hyperlipidemia who have high cardiovascular risk.