CAJ | 학술논문

目的比较强化脂必泰及阿托伐他汀治疗对血脂异常的冠心病中、高危患者的调脂、抗炎疗效及安全性.方法血脂异常的冠心病中、高危患者169例,随机分为脂必泰组和阿托伐他汀组.于治疗前及治疗后4周、8周分别检测高敏C反应蛋白(hs-CRP)、P-选择素、基质金属蛋白酶(MMP)-9和可溶性细胞间黏附因子-1(SICAM-1)等.结果与治疗前比较,治疗后4、8周两组TC、LDL-C显著下降,HDL-C升高.脂必泰组治疗4、8周后TG从(2.22±0.62)mmol/L分别下降至(2.05±0.70、1.77±0.75)mmol/L(P<0.05);而他汀组治疗4周与治疗前比较TG无显著下降,治疗8周后TG显著下降[(2.28±0.61)mmol/L～(1.79±0.66)mmol/L,P<0.05];与治疗前相比,两组治疗8周后P-选择素、MMP-9、SICAM-1、hs-CRP等炎症因子较治疗前均明显降低(各组P值均<0.01),两组治疗前后肝肾功能、肌酶变化、肌病发生率和消化道反应发生率差异无统计学意义(P>0.05).结论强化脂必泰治疗能有效调脂并降低血脂异常患者的炎症因子,且临床应用安全.
목적 비교강화지필태급아탁벌타정치료대혈지이상적관심병중、고위환자적조지、항염료효급안전성.방법 혈지이상적관심병중、고위환자169례,수궤분위지필태조화아탁벌타정조.우치료전급치료후4주、8주분별검측고민C반응단백(hs-CRP)、P-선택소、기질금속단백매(MMP)-9화가용성세포간점부인자-1(SICAM-1)등.결과 여치료전비교,치료후4、8주량조TC、LDL-C현저하강,HDL-C승고.지필태조치료4、8주후TG종(2.22±0.62)mmol/L분별하강지(2.05±0.70、1.77±0.75)mmol/L(P<0.05);이타정조치료4주여치료전비교TG무현저하강,치료8주후TG현저하강[(2.28±0.61)mmol/L～(1.79±0.66)mmol/L,P<0.05];여치료전상비,량조치료8주후P-선택소、MMP-9、SICAM-1、hs-CRP등염증인자교치료전균명현강저(각조P치균<0.01),량조치료전후간신공능、기매변화、기병발생솔화소화도반응발생솔차이무통계학의의(P>0.05).결론 강화지필태치료능유효조지병강저혈지이상환자적염증인자,차림상응용안전.
Objective To compare the lipid lowing effect and the clinical safety between intensive therapy with Chinese medicine Zhihitai and atorvastntin in patients with moderate and high risk of atherosclerosis. Methods All the patients were randomly divided in to a Zhibitai group (n = 85) receiving 480 mg of Zhibitai orally twice a day or an atorvastatin group (n = 84) receiving 10 mg atorvastatin orally once daily. Blood lipoproteins, myocardial enzymes, fiver and renal function were measured before treatment and at the fourth and eighth week after therapy , while high sensitive creactive protein (hs-CRP), P-selectin, matrix-metall proteinase-9 (MMP-9) and soluble intercellular adhering molecule-1 (SICAM-1) were detected before treatment and eighth week after therapy in all patients. Results TC and LDL-C were significantly decreased while HDL-C was increased in both groups after 4 and 8 weeks treatment (P < 0. 05). TG was decreased in Zhibitai group after 4 and 8 weeks of treatment, but it was decreased in atorvastatin group only after 8 weeks of treatment. Inflammatory factors such as hs-CRP, P-selectin, MMP-9, SICAM-1 were decreased significantly (all P < 0. 01), but there was no significant difference between the two groups. There were no difference in liver and kidney function, myocardial enzymes and incidence of muscle-ache and digestive system side reaction. ConclusionsBesides the lipoprotein disorder, inflammatory factors in patients with moderate and high risk of atherosclerosis could be regulated with intensive therapy of Zhibitai. Most importantly, it is safe to use Zhibitai clinically.