目的 评价小剂量普伐他汀加用微粒化非诺贝特治疗冠心病及其等危症合并混合性血脂异常的临床疗效.方法 选择首都医科大学附属复兴医院收治的冠心病或具有冠心病等危症合并混合型血脂异常患者142例,随机分A、B两组,各71例.A组采用普伐他汀加用微粒化非诺贝特(200 mg/d)治疗,B组单用普伐他汀(20 mg/d)治疗,疗程均为24周.比较两组患者的调脂疗效和心血管事件的发生情况.结果 与基线比较两组总胆固醇、三酰甘油、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇的水平在24周下降幅度分别为21%和9%(P＜0.05)、40%和3%(P＜0.01)、22%和14%(P＜0.01)、28%和6%(P＜0.01),高密度脂蛋白胆固醇上升分别为10%和5%(P＜0.05),差异均有统计学意义.结论 普伐他汀加用微粒化非诺贝特治疗冠心病及其等危症合并混合性血脂异常患者血脂代谢紊乱的效果佳,且未发现更显著地降低心血管事件的风险.%Objective To evaluate the efficacy of combination therapy with pravastatin and micronised fenofibrate in coronary heart disease( CHD )and CHD risk equivalents patients with complex dyslipidemia. Methods 142 eligible patients from Fuxing Hospital Affiliated to Capital Medical University were enrolled, who were randomly divided into group A,B of 71 cases each. Group A received pravastatin 20 mg/d plus fenofibrate 200 mg/d combination therapy. Group B received pravastatin 20 mg/d monotherapy. The courses of treatment were both 24 weeks. Lipid regulation efficacy and occurrence of cardiovascular events of the two groups were compared. Results Compared to baseline after 24 weeks treatment of the two groups,mean TC levels decreased by 21% and 9%( P <0. 05 ),mean TG levels decreased by 40% in group A and 3% in group B( P <0. 01 ),mean LDL-C levels decreased by 22% and 14%( P <0. 01 ),mean NHDL-C levels decreased by 28% and 6%( P <0. 01 ),mean HDL-C levels increased by 10% and5%( P <0. 05 ),the differences between the two groups were all statistically significant. Conclusion Pravastatin combined with micronised fenofibrate is effective in CHD and CHD risk equivalent patients with complex dyslipid to correct the dyslipidemia without significantly reduced cardiovascular risk.
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