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目的探讨应用烟酸缓释片治疗急性冠脉综合征伴混合性高脂血症的临床疗效及安全性。方法共入选72例患者,随机分为阿伐他汀组(10 mg/d,n=38)和烟酸缓释片治疗组(500 mg/d,n=34),疗程均为4周,观察治疗前后主要血脂参数的变化率、达标率、不良反应及血浆肿瘤坏死因子(TNFα)及 C 反应蛋白(CRP)的变化。结果 (1)烟酸缓释片在降低甘油三酯(TG)、脂蛋白(a)[Lp(a)]、升高高密度脂蛋白(HDL-C)方面优于他汀类药物,二药物对肝肾功能影响均没有统计学意义上的差异,但烟酸缓释片治疗组较高比例患者出现皮肤潮红和瘙痒。(2)二者均可以降低血清 TNFα和 CRP 水平。结论与他汀类相比,烟酸缓释片可高效地升高 HDL-C,降低 TG 和 Lp(a),并具有良好的安全性,同时提示烟酸缓释片也可能具有抗炎的疗效。
Objective To investigate the clinical efficacy and safety of niacin sustained-release tablets in the treatment of acute coronary syndrome with mixed hyperlipidemia. Methods A total of 72 patients were randomly assigned to atorvastatin group (n = 38) and niacin sustained-release tablets group (n = 34). The course of treatment was 4 weeks. The changes of main blood lipid parameters before and after treatment, the compliance rate, the adverse reactions and the changes of plasma tumor necrosis factor (TNFα) and C-reactive protein (CRP). Results (1) Nicotinic acid sustained-release tablets were superior to statins in lowering triglyceride (TG), lipoprotein (a) [Lp (a)] and increasing high density lipoprotein (HDL-C) There was no statistically significant difference in the effects on liver and kidney function, but a higher proportion of niacin sustained-release tablets treated patients developed skin flushing and itching. (2) Both can lower serum TNFα and CRP levels. Conclusion Compared with statins, niacin sustained-release tablets can effectively increase HDL-C, reduce TG and Lp (a), and have good safety, and also suggest that niacin sustained-release tablets may also have anti-inflammatory effects .