摘要
目的探讨他汀联合依折麦布对急性ST段抬高型心肌梗死(STEMI)合并非透析依赖的慢性肾脏病(CKD)患者调脂治疗的有效性和安全性。方法选取2017年2月至2019年4月在该院住院的29例使用阿托伐他汀联合依折麦布调脂治疗的STEMI合并非透析依赖的CKD患者作为观察组,以同期性别、年龄和临床资料匹配的38例单用阿托伐他汀的STEMI合并非透析依赖的CKD患者作为对照组,观察治疗3~6个月后两组血脂的达标率及安全性。结果两组患者年龄、性别、既往病史、冠状动脉病变特征、心功能和主要药物治疗无明显差异(P>0.05)。两组患者治疗后低密度脂蛋白(LDL)水平较治疗前均明显降低(P<0.05),且观察组低于对照组[(2.0±0.6)mmol/L vs.(2.3±0.4)mmol/L,P<0.05]。观察组LDL达标率明显高于对照组(58.6%vs.18.4%,P=0.001)。两组各有1例转氨酶升高,肌酐水平在治疗前后无明显差异(P>0.05)。两组患者随访6个月主要心血管不良事件发生率无明显差异(P>0.05)。结论STEMI合并非透析依赖的CKD患者他汀联合依折麦布调脂治疗较单用他汀能显著降低LDL水平,提高LDL达标率,且相对安全,对心血管事件的影响需进一步随访评估。
Objective To explore the safety and efficacy of statins combined with ezetimibe in the lipid-lowering treatment in patients with ST-elevation myocardial infarction(STEMI)complicating non-dialysis-dependent chronic kidney disease(CKD).Methods Twenty-nine inpatients with STEMI complicating non-dialysis-dependent CKD treated by atorvastatin combined with ezetimibe in this hospital from February 2017 to April 2019 were selected as the observation group,and contemporaneous 38 cases of STEMI complicating non-dialysis-dependent CKD matched by age,gender and clinical data treated by single atorvastatin were served as the control group.The blood lipid reaching standard rate and safety after 3-6 months treatment were observed in the two groups.Results The age,gender,past medical history,characteristics of coronary artery lesion,cardiac function and main medications had no statistically significant difference between the two groups(P>0.05).After treatment,the low density lipoprotein(LDL)level in both groups was significantly decreased compared with before treatment(P<0.05),moreover the observation group was lower than the control group[(2.0±0.6)mmol/L vs.(2.3±0.4)mmol/L,P<0.05].The LDL reaching standard rate in the observation group was higher than that in the control group(58.6%vs.18.4%,P=0.001).There was 1 case of aminotransferase increase in each group,and the creatinine level had no significant change before and after treatment in both groups(P>0.05).The occurrence rate of major adverse cardiovascular events during 6-month follow up had no statistically significant difference between the two groups(P>0.05).Conclusion Compared with single statin treatment,statins combined with ezetimibe can significantly decrease the LDL level,increase the LDL reaching standard rate,moreover is relatively safe,but its effect on the major adverse cardiovascular events needs to be evaluated by further follow up.
作者
黄毕
胡贤康
甘宏薄
向珍贤
竺源松
罗素新
HUANG Bi;HU Xiankang;GAN Hongbo;XIANG Zhenxian;ZHU Yuansong;LUO Suxin(Department of Cardiology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
CAS
2021年第16期2758-2763,共6页
Chongqing medicine
基金
中国心血管健康联盟血脂异常及动脉粥样硬化研究基金(2017-CCA-Msdlipid-015)。
关键词
ST段抬高心肌梗
慢性肾脏病
他汀类
依折麦布
有效性
安全性
ST segment elevation myocardial infarction
chronic kidney disease
statins
ezetimibe
efficiency
safety
