CAJ | 학술논문

目的：观察瑞舒伐他汀联合非诺贝特对冠心病合并2型糖尿病患者的调脂疗效与安全性。方法选择住院确诊为冠心病合并2型糖尿病且血清甘油三酯（TG）水平升高和／或高密度脂蛋白胆固醇（HDL‐C）降低的94例患者为研究对象，在常规治疗基础上随机分为2组：对照组（47例），给予瑞舒伐他汀10 mg每晚1次；治疗组（47例），给予瑞舒伐他汀10 mg每晚1次、微粒化非诺贝特200 mg ，每日1次。分别于治疗前、治疗4周和8周后检测血清总胆固醇（TC）、TG、低密度脂蛋白胆同醇（LDL‐C）和HDL‐C水平，记录不良反应及临床事件。结果治疗4周后，两组 TC、TG、LDL‐C水平均明显低于用药前，治疗8周后降低更为明显（P均＜0.05），8周末治疗组下降幅度大于对照组（P＜0.05）。两组治疗后 HDL‐C均升高，8周后升高更明显（P＜0.05），对照组HDL‐C升高幅度为21.7％，治疗组23.9％，但两组比较无统计学差异（P＞0.05）。治疗8周后，治疗组LDL‐C、TG、HDL‐C、3项血脂指标均达标和非HDL‐C的达标率均明显高于对照组（P＜0.05）。治疗期间两组均未观察到严重不良反应。结论伴T G升高和／或HDL‐C降低的冠心病合并2型糖尿病患者联合应用瑞舒伐他汀和非诺贝特治疗有助于血脂的全面达标，且安全性良好。
목적：관찰서서벌타정연합비낙패특대관심병합병2형당뇨병환자적조지료효여안전성。방법선택주원학진위관심병합병2형당뇨병차혈청감유삼지（TG）수평승고화／혹고밀도지단백담고순（HDL‐C）강저적94례환자위연구대상，재상규치료기출상수궤분위2조：대조조（47례），급여서서벌타정10 mg매만1차；치료조（47례），급여서서벌타정10 mg매만1차、미립화비낙패특200 mg ，매일1차。분별우치료전、치료4주화8주후검측혈청총담고순（TC）、TG、저밀도지단백담동순（LDL‐C）화HDL‐C수평，기록불량반응급림상사건。결과치료4주후，량조 TC、TG、LDL‐C수평균명현저우용약전，치료8주후강저경위명현（P균＜0.05），8주말치료조하강폭도대우대조조（P＜0.05）。량조치료후 HDL‐C균승고，8주후승고경명현（P＜0.05），대조조HDL‐C승고폭도위21.7％，치료조23.9％，단량조비교무통계학차이（P＞0.05）。치료8주후，치료조LDL‐C、TG、HDL‐C、3항혈지지표균체표화비HDL‐C적체표솔균명현고우대조조（P＜0.05）。치료기간량조균미관찰도엄중불량반응。결론반T G승고화／혹HDL‐C강저적관심병합병2형당뇨병환자연합응용서서벌타정화비낙패특치료유조우혈지적전면체표，차안전성량호。
Objective To observe the effect and security of combined treatment of rosuvastatin and fenofibrate in coronary heart disease patients with diabetes mellitus .Methods 94 hospitalized cases of coronary heart disease with type 2 diabetes com‐bined with serum high triglyceride (TG) levels and /or reduced high density lipoprotein cholesterol (HDL‐C) were selected and randomly divided into two groups on the basis of conventional treatment :control group (47 cases) ,given rosuvastatin 10 mg every night ;the treatment group (47 cases) ,given rosuvastatin 10 mg every night ,micronized fenofibrate 200 mg ,1 times a day .The level of total cholesterol (TC) ,TG ,low density lipoprotein cholesterol (LDL‐C) and HDL‐C were respectively detec‐ted in before treatment ,4 weeks and 8 weeks after treatment .Adverse reactions and clinical events were recorded .Results Af‐ter 4 weeks of treatment ,the levels of TC ,TG ,LDL‐C in two groups were significantly lower than that before treatment .After 8 weeks of treatment ,decreased significantly(P<0.05) .The drop of treatment group were higher than that of control group in 8th weekend (P< 0.05) .HDL‐C increased in two groups after treatment .HDL‐C obviously increased after 8 weeks (P<0.05) ,by 21.7% in control group ,23.9% in the treatment group ,but there is no statistical difference in two groups ( P>0.05) .After 8 weeks ,LDL‐C ,TG ,HDL‐C ,3 blood lipids in the treatment group are standard .Non HDL‐C standard rate were significantly higher than that of the control group (P<0.05) .During the treatment ,there were no serious adverse events in two groups .Conclusion The combined treatment of rosuvastatin and fenofibrate on coronary heart disease with type 2 diabetes with high triglyceride (TG) levels and/or reduced HDL‐C help blood lipid comprehensive standards ,and has good security .