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目的观察他汀类和贝特类药联合治疗以甘油三酯升高为主的混合型高脂血症的疗效和安全性。方法混合型高脂血症患者98例,随机分为性别、年龄、血脂各指标水平匹配的2组:治疗组46例,每晚口服10 mg阿托伐他汀,每日加服非诺贝特0.25 g;对照组52例,每晚口服10 mg阿托伐他汀。服药期间患者需改变饮食习惯,进行低脂饮食。观察治疗1个月和2个月后血脂水平的变化及不良反应。结果与治疗前比较,2组治疗后TC、LDL-C水平均有不同程度的降低(P均<0.05),高密度脂蛋白胆固醇升高不明显(P均>0.05)。治疗后治疗组甘油三酯水平明显低于对照组(P<0.01)。治疗组TG水平较治疗前显著下降(P均<0.01),对照组TG水平无明显变化(P均>0.05)。治疗组谷丙转氨酶和谷草转氨酶均升高者1例,升高幅度达正常值2倍,停用降脂药后恢复正常;肌酸激酶轻度升高者1例,未做特殊处理,2周后复查恢复正常。所有患者未见肌痛。结论以甘油三酯升高为主的混合型高脂血症患者采用阿托伐他汀与非诺贝特联用治疗安全有效,密切监测肝酶和肌酸激酶对保障两药联合安全应用至关重要。
Objective To observe the efficacy and safety of combination of statins and fibrates in the treatment of mixed hyperlipidemia, which is mainly triglyceride. Methods A total of 98 patients with mixed hyperlipidemia were randomly divided into two groups with the same level of sex, age and blood lipid: 46 in the treatment group and 10 mg of atorvastatin orally in the evening. The daily doses of fenofibrate 0.25 g; control group of 52 patients, oral administration of 10 mg atorvastatin per night. During the medication patients need to change their diet, low-fat diet. The changes of blood lipid level and adverse reactions after 1 month and 2 months of treatment were observed. Results Compared with those before treatment, the levels of TC and LDL-C in both groups decreased to different extents (all P <0.05) and the levels of HDL cholesterol did not increase significantly (all P> 0.05). After treatment, the level of triglyceride in the treatment group was significantly lower than that in the control group (P <0.01). The level of TG in treatment group decreased significantly (P <0.01), while the level of TG in control group had no significant change (all P> 0.05). In the treatment group, 1 case of elevated alanine aminotransferase and aspartate aminotransferase were elevated by 2 times of the normal value, and returned to normal after stopping the lipid lowering drug. One case of mild elevation of creatine kinase was treated with no special treatment, 2 Week review returned to normal. No myalgia in all patients. Conclusions The combination of atorvastatin and fenofibrate in combination hyperlipidemia patients with elevated triglycerides is safe and effective, and close monitoring of liver enzymes and creatine kinase is essential for ensuring the safety of the two drugs in combination important.