标题：辛伐他汀联合非诺贝特治疗混合性高脂血症63例疗效观察

      作者：何名梅 1，苏国生 2，劳炳焕 3
    1.北流市妇幼保健院，广西 北流 537400；
2.南宁市第四人民医院，广西 南宁 530023；
3.合浦县红十字会医院，广西 合浦 536100）

      卷次： 2013年24卷3期

      【摘要】 目的 观察辛伐他汀联合非诺贝特治疗混合性高脂血症的疗效及安全性。方法 126例混合性高
脂血症患者随机分为两组各63例，观察组每天清晨口服非诺贝特微粒化胶囊100 mg，夜间口服辛伐他汀10 mg，
对照组每晚顿服辛伐他汀20 mg，两组疗程均为12周。观察两组治疗前后主要血脂参数的变化率、疗效、达标率
及不良反应。结果 治疗后观察组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、高密度脂蛋
白胆固醇（HDL-C）水平均低于对照组，t分别为6.304 8、6.694 6、31.768 1、6.281 0，P均<0.01，差异有统计学意义；
观察组总有效率高于对照组，χ2=6.98，P<0.01，差异有统计学意义；观察组LDL-C、TG、TC 3项达标均高于对照
组，χ2分别为4.67、6.30、5.03，P均<0.05，差异有统计学意义；观察组丙氨酸氨基转移酶（ALT）轻度升高2例，对照
组3例，均小于正常值3倍，差异无统计学意义；两组肌酸激酶（CK）无明显变化，未出现肌病症状。结论 辛伐
他汀联合非诺贝特治疗混合性高脂血症临床效果明显，具有良好的安全性。

      【关键词】 辛伐他汀；非诺贝特；高脂血症

      【中图分类号】 R589.2 【文献标识码】 A 【文章编号】 1003—6350（2013）03—0332—03


·论 著·
高血脂症是由于脂肪代谢或运转出现异常而使
血浆中一种或多种脂质高于正常参考值的症状。高
血脂症是一种全身性的疾病，由于血中胆固醇(TC)
和/或甘油三酯 (TG)过高或高密度脂蛋白胆固醇
(HDL-C)过低造成。高血脂症为心肌梗死、猝死、脑
卒中、冠心病的危险因素，还是促进糖尿病、糖耐量异
常及高血压的重要危险因子，同时可导致肝硬化、胆
石症、脂肪肝、周围血管疾病、跛行、高尿酸血症、胰腺
doi:10.3969/j.issn.1003-6350.2013.03.0147
Clinical effect of simvastatin combined with fenofibrate in the treatment of hyperlipidemia.
HE Ming-mei 1, SU
Guo-sheng 2, LAO Bin-huan 3. 1. Beiliu Maternal and Child Health Hospital, Beiliu 537400, Guangxi, CHINA; 2. The
Fourth People's Hospital of Nanning City, Nanning 530023, Guangxi, CHINA; 3. Red Cross Hospital of Hepu County,
Hepu 536100, Guangxi, CHINA

【Abstract】 Objective To observe the clinical effect and safety of simvastatin combined with fenofibrate in
the treatment of mixed hyperlipidemia. Methods One hundred and twenty-six patients with mixed hyperlipidemia
were randomly divided into two groups, each with 63 cases. Patients in the observation group took orally micronised
fenofibrate 100 mg in the morning and simvastatin 10 mg at night, while those in the control group received simvas-
tatin 20 mg at night. All the patients were treated for 12 weeks. The rate of change of the major lipid parameters be-
fore and after treatment was observed, as well as the clinical efficacy, incidence of compliances and adverse reactions.
Results For lipid parameters, the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyc-
erides (TG), high density lipoprotein cholesterol (HDL-C) were significantly lower in the observation group than the
control group (t=6.304 8, 6.694 6, 31.768 1, 6.281 0, respectively, P<0.01). In the comparison of clinical efficacy, the to-
tal effective rate in the observation group was significantly higher than that in the control group (χ2=6.98, P<0.01). The
general ratio of reaching standard for LDL-C、TG、TC were significantly higher in the observation group (χ 2=4.67,
6.30, 5.03, P<0.05). Increased alanine amino transferase (ALT) levels were found in two patients of the observation
group and three patients of the control group, lower than 3 times of the normal value, with no statistically significant
difference. The two groups showed no significant difference in creatine kinase (CK), with no symptoms of myopa-
thy. Conclusion Simvastatin combined with fenofibrate is quite effective and safe for treating mixed hyperlipidemia.