依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响

王振华; 张倩; 刘建平; 钟理; 张志辉; 舒茂琴; 胡厚源; 迟路湘; 景涛; 宋治远; 仝识非

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依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响

临床医学 | 更新时间：2026-01-09

- 依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响
- Effect of ezetimibe on lipid metabolism and carotid plaque in patients with coronary heart disease
- 陆军军医大学学报 2016年38卷第21期页码：2345-2348
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  中图分类号： Q591.5;R541.4;R972.6
- 纸质出版：2016
- 稿件说明：
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王振华,张倩,刘建平,钟理,张志辉,舒茂琴,胡厚源,迟路湘,景涛,宋治远,仝识非.依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(21):2345-2348.

　Wang Zhenhua,Zhang Qian,Liu Jianping,Zhong Li,Zhang Zhihui,Shu Maoqin,Hu Houyuan,Chi Luxiang,Jing Tao,Song Zhiyuan,Tong Shifei.Effect of ezetimibe on lipid metabolism and carotid plaque in patients with coronary heart disease[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(21):2345-2348.
王振华,张倩,刘建平,钟理,张志辉,舒茂琴,胡厚源,迟路湘,景涛,宋治远,仝识非.依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响[J].陆军军医大学学报(原第三军医大学学报),2016,38(21):2345-2348. DOI：

　Wang Zhenhua,Zhang Qian,Liu Jianping,Zhong Li,Zhang Zhihui,Shu Maoqin,Hu Houyuan,Chi Luxiang,Jing Tao,Song Zhiyuan,Tong Shifei.Effect of ezetimibe on lipid metabolism and carotid plaque in patients with coronary heart disease[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(21):2345-2348. DOI：

摘要

目的探讨依折麦布对冠心病患者血脂代谢及颈动脉斑块的影响。方法选取我科2013年9月至2014年9月确诊的冠心病患者96例（男性68例，女性28例），按随机数字表法分为观察组（n=48，采用依折麦布10 mg/d联合瑞舒伐他汀10 mg/晚）与对照组（n=48，仅用瑞舒伐他汀10 mg/晚），给予标准的冠心病二级预防治疗。分别在治疗前、治疗后6个月及1年检测患者血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDLC）水平，并比较两组患者治疗1年前后超敏C反应蛋白（hsCRP）、颈动脉粥样斑块变化及不良心血管事件发生率。结果 ①两组患者治疗后TC、TG、LDLC及hsCRP水平均显著低于治疗前；与对照组相比较，观察组TC、LDL-C及hs-CRP 水平下降更为显著[（3.21±0.58）mmol/L vs （3.72±0.80） mmol/L、（1.87±0.43）mmol/L vs （2.33±0.64）mmol/L、（1.31±1.73）mg/L vs （2.27±2.69）mg/L，P0.05]。②观察组患者治疗后颈动脉斑块积分显著低于治疗前[（3.2±1.2）mm vs （4.2±1.5）mm，P0.05]，亦明显好于对照组[（3.2±1.2）mm vs （3.8±1.4）mm，P0.05]。对照组患者治疗前后颈动脉斑块积分无明显差异（P0.05）。③观察组患者随访期间再发不稳定型心绞痛1例（2.1%），稳定型心绞痛2例（4.2%），主要不良心血管事件总发生率为6.3%，显著低于对照组（6.3% vs 22.8%，P0.05）。结论依折麦布联合他汀类药物可更好改善冠心病患者的血脂水平与炎性因子，延缓甚至逆转颈动脉粥样硬化进程，减少主要不良心血管事件发生。

Abstract

Objective To determine the effect of ezetimibe on lipid metabolism and carotid plaque in the patients with coronary heart disease (CHD). Methods A total of 96 confirmed CHD patients (68 males and 28 females) admitted in our department from September 2013 to September 2014 were subjected in this study. They were randomly divided into the observation group (combined treatment with 10 mg/d ezetimibe and 10 mg/d rosuvastatin) and control group (only with 10 mg/d rosuvastatin). Standard secondary prevention and treatment for CHD were given to all the patients. The levels of total cholesterol (TC)

triglyceride (TG)

high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected before and in 6 to 12 months after treatment. The level of hypersensitive C-reactive protein (hs-CRP)

Crouse score of carotid artery plaque and incident rate of adverse cardiovascular events were compared between the 2 groups before and after 1 year’s treatment. Results ①After the treatment

the levels of TC

LDL-C and hs-CRP were significantly lower in the 2 groups. Comparing with control group

the declines of TC

LDL-C and hs-CRP were more significant in the observation group (3.21±0.58 vs 3.72±0.80 mmol/L

1.87±0.43 vs 2.33±0.64 mmol/L

1.31±1.73 vs 2.27±2.69 mg/L

P0.05). ②The Crouse score of carotid artery plaque was significantly decreased after treatment in the observation group (3.2±1.2 vs 4.2±1.5 mm

P0.05)

better than the control group (3.2±1.2 vs 3.8±1.4 mm

P0.05). No difference was seen in the score in the control group before and after treatment (P0.05). ③The incidence of adverse cardiovascular events was 2.1% for unstable angina pectoris (1 case) and 4.2% for stable angina pectoris (2 cases) in the observation group

and the total incidence of the events was remarkably lower in the observation group than the control group (6.3% vs 22.8%

P0.05). Conclusion Ezetimibe combined with rosuvastatin can improve the levels of lipids and inflammation factors

slow even recover the progress of carotid atherosclerosis and reduce the incidence of adverse cardiovascular events in the CHD patients.

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