依折麦布联合辛伐他汀治疗膜性肾病合并高脂血症的临床观察

摘要

目的：观察依折麦布联合辛伐他汀治疗膜性肾病合并高脂血症的临床疗效及安全性。方法：将90例膜性肾病合并高脂血症患者按随机数字表法分为观察组和对照组，各45例。两组患者均进行健康指导，给予低脂饮食，不使用其他调血脂、护肝以及对血脂代谢有干扰的药物。对照组患者口服辛伐他汀片20 mg，qd；观察组患者在对照组基础上加服依折麦布片10 mg，qd。两组患者均治疗8周。观察两组患者膜性肾病和高脂血症的临床疗效，并比较治疗前及治疗后2、4、8周时的血脂水平[总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、尿蛋白定量、肌酸激酶（CK）水平和不良反应发生情况。结果：观察组患者膜性肾病和高脂血症的总有效率分别为95.56％和93.33％，显著高于对照组的73.33％和75.56％，差异有统计学意义（P＜0.05）。两组患者治疗前及治疗后2、4、8周TG、HDL-C、LDL-C水平，治疗前及治疗后2、4周TC水平比较，差异均无统计学意义（P＞0.05）；治疗8周后，观察组患者TC水平显著低于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前及治疗后2、4、8周AST、ALT、尿蛋白定量、CK水平比较，差异均无统计学意义（P＞0.05）。两组患者不良反应发生率比较，差异亦无统计学意义（P＞0.05）。结论：依折麦联合布辛伐他汀治疗膜性肾病合并高脂血症临床疗效显著，能有效降低患者TC水平，且安全性较好。%OBJECTIVE:To observe the clinical efficacy and safety of ezetimibe combined with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia. METHODS:90 patients with membranous nephropathy complicated with hyperlipidemia were randomly divided into observation group and control group,45 cases in each group. All patients received health guidance,low-fat diet,and the drugs without interfere with regulating lipid,hepatoprotective and lipid metabolism were for-bid. Control group was orally given 20 mg Simvastatin tablet,qd;observation group was additionally given 10 mg Ezetimibe tab-let,qd. They were treated for 8 weeks. Clinical efficacy was observed,lipid levels [total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C)],aspartate aminotransferase (AST),ala-nine aminotransferase(ALT),urinary protein quatitation,creatine kinase(CK)before and 2,4,8 weeks after treatment,and the incidence of adverse reactions were compared. RESULTS:Total effective rates of membranous nephropathy and hyperlipidemia were 95.56% and 93.30% in observation group,which were significantly higher than 73.33% and 75.56% in control graup,with statistical significance (P<0.05) .There were no significant differences in TG,HDL-C and LDL-C levels before and 2,4,8 weeks after treatment,and TC level before and 2,4 weeks after treatment between 2 groups (P>0.05);after 8 weeks of treat-ment,TC level in observation group was significantly lower than control group,the differences were statistically significant (P<0.05). Compared with control group,there were no significant differences in AST,ALT,urinary protein quatitation and CK level between 2 groups before and 2,4,8 weeks after treatment(P>0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Ezetimibe shows similar clinical efficacy with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia,it can effectively reduce TC level,with good safety.