摘要
目的比较冠状动脉狭窄50％-70％的冠心病人群中，40mg阿托伐他汀与10mg阿托伐他汀和10mg依折麦布联合治疗的调脂作用和安全性。探讨单用他汀治疗和联合治疗对基质金属蛋白酶（MMP）的影响。方法选取冠状动脉狭窄50％-70％的冠心病患者42例（不置入支架），分为较大剂量阿托伐他汀（40mg）组（单用他汀组）19例和小剂量阿托伐他汀（10mg）联合依折麦布（10mg）组（联合治疗组）23例。在服药前，用药4周，用药12周分别测定总胆固醇（TC），甘油三酯，低密度脂蛋白胆固醇（LDL-C），高密度脂蛋白胆固醇，肝功能，肾功能，肌酸激酶，基质金属蛋白酶-2（MMP-2），基质金属蛋白酶-9（MMP-9），基质金属蛋白酶组织抑制因子-1（TIMP-1）。结果（1）单用他汀组和联合治疗组均在4周就可以明显降低患者的TC，LDL-C。12周时单用他汀组的LDL-C是（1.94±0.49）mmol／L，较前下降37.82％，联合治疗组的LDL-C是（1.92±0.54）mmol／L，较前下降38.26％，两组之间差异无统计学意义。（2）单用他汀组和联合治疗组的患者肝功能，肾功能，肌酸激酶在用药后无明显升高。（3）单用他汀组的MMP-2，MMP-9在12周时均较基线有明显降低，TIMP-1有明显升高。结论（1）单用他汀治疗和联合治疗降脂疗效无差异。（2）两种治疗都没有引起患者肝、肾功能异常和肌酶异常。（3）40mg阿托伐他汀治疗明显降低患者MMP-2、MMP-9，升高TIMP-1。
Objective Patients with coronary artery disease （CAD, stenosis between 50%-70% evidenced by coronary angiography） were treated with atorvastatin 40 mg （n = 19） or atorvastatin 10 mg in combination with ezetimibe 10 mg （n = 23 ）. Blood lipid profile and metalloproteinases were monitored up to 3 months. Methods Cholesterol （TC） , triglycerides （TG） , low-density lipoprotein cholesterol （LDL-C） , high-density lipoprotein cholesterol （ HDL-C ） , liver function, renal function, creatine kinase, MMP-2, MMP-9, TIMP-1 were measured at baseline and at 1 month and 3 months post therapy. Results （1） At 3 months, LDL-C was similarly reduced in monotherapy group [（1.94±0.49） mmol/L, 37.82% reduction compared to baseline ] and in combined therapy group [（1.92±0.54） mmol/L, 38.26% reduction compared to baseline]. （2） AST, ALT, renal function and creatine kinase remained unchanged post various therapy （all P 〉0.05）. （3） MMP-2, MMP-9 significantly decreased and TIMP-1 significantly increased at 3 months compared to baseline in monotherapy group but these parameters remained unchanged in combined therapy group. Conclusion Both therapy regimens were well tolerated and similarly effectively reduced blood lipids and 40 mg atorvastatin monotherapy regimen is superior to atorvastatin 10 mg plus ezetimibe 10 mg regimen in improving metalloproteinases parameters.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2009年第5期417-421,共5页
Chinese Journal of Cardiology
