低剂量阿托伐他汀联合依折麦布治疗缺血性卒中病人高脂血症的效果

何春; 邰迎东; 吴翔

doi:10.13898/j.cnki.issn.1000-2200.2019.10.016

低剂量阿托伐他汀联合依折麦布治疗缺血性卒中病人高脂血症的效果

Effect of low-dose of atorvastatin combined with ezetimibe in the treatment of hyperlipidemia in patients with ischemic stroke

摘要

摘要:
目的探讨缺血性卒中病人应用低剂量阿托伐他汀联合依折麦布降低血脂的疗效和安全性，并分析联合用药在脑卒中二级预防中的作用。
方法回顾性总结128例缺血性卒中合并高脂血症病人的临床资料，根据其用药情况将病人分为3组，未规律服用降脂药超过6个月的病人纳入对照组，阿托伐他汀组（40 mg）和合剂组（阿托伐他汀20 mg联合依折麦布），对比各组病人治疗前和治疗6个月的血脂变化情况，统计各组2年内缺血性卒中终点事件、心血管意外、周围血管闭塞和其他不良反应的发生情况。
结果3组病人治疗6个月后三酰甘油、总胆固醇和低密度脂蛋白胆固醇水平均低于治疗前（P < 0.05~P < 0.01），而高密度脂蛋白胆固醇差异无统计学意义（P>0.05）；阿托伐他汀组和合剂组治疗后三酰甘油、总胆固醇和低密度脂蛋白胆固醇显著高于对照组（P < 0.01），而阿托伐他汀组和合剂组间差异无统计学意义（P>0.05）。阿托伐他汀组和合剂组因缺血性卒中再次发作而住院治疗者均少于对照组（P < 0.05），而合剂组和阿托伐他汀组间差异无统计学意义（P>0.05）。阿托伐他汀组和合剂组心血管意外的发生率低于对照组（P < 0.05）。阿托伐他汀组和合剂组病人不良反应发生率差异无统计学意义（P>0.05）。
结论缺血性卒中合并高脂血症，尤其合并混合型高脂血症病人应用低剂量阿托伐他汀联合依折麦布，可安全有效地达到更佳的降脂效果，且在脑卒中二级预防及减少心血管意外事件方面提供相似的保护作用。

Abstract:
ObjectiveTo investigate the efficacy and safety of low dose of atorvastatin combined with ezetimibe in the treatment of hyperlipidemia in patients with ischemic stroke, and analyze its effect in the secondary prevention of stroke.
MethodsThe clinical data of 128 patients with ischemic stroke complicated with hyperlipidemia were divided into the control group(treatment with taking lipid-lowering drugs for more than 6 months), atorvastatin group(treatment with 40 mg of atorvastatin) and combination group(20 mg of atorvastatin combined with ezetimibe).The levels of blood lipid before and after 6 months of treatment, and occurrence rates of ischemic stroke end event, cardiovascular event, peripheral vascular occlusion and other adverse reactions after 2 years of treatment were compared among three groups.
ResultsAfter 6 months of treatment, the levels of triglyceride(TG), total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) in three groups were lower than those before treatment(P < 0.05 to P < 0.01), and the differences of the level of high-density lipoprotein cholesterol among three groups were not statistically significant(P>0.05).After treatment, the levels of TG, TC and LDL-C in atorvastatin group and combination group were significantly higher than those in control group(P < 0.01), and the differences of those between atorvastatin group and combination group were not statistically significant(P>0.05).The patients with hospitalization for recurrent ischemic stroke in atorvastatin group and combination group were significantly lower than that in control group(P < 0.05), and the difference of which between atorvastatin group and combination group was not statistical significance(P>0.05).The occurrence rates of cardiovascular event in atorvastatin group and combination group were significantly lower than that in control group(P < 0.05).There was no statistical significance of the incidence rate of adverse reaction between atorvastatin group and combination group(P>0.05).
ConclusionsThe low-dose of atorvastatin combined with ezetimibe can effectively and safely reduce the blood lipid level of the patients with ischemic stroke complicated with hyperlipidemia, especially complicated with hybrid hyperlipidemia, and provide a similar protective effect in the secondary prevention of stroke and reducing cardiovascular events.

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