阿托伐他汀联合依折麦布治疗动脉粥样硬化性非闭塞性肠系膜缺血的临床效果

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摘要目的探讨阿托伐他汀联合依折麦布治疗动脉粥样硬化性非闭塞性肠系膜缺血的临床效果及对患者血脂水平、炎性指标、血管内皮功能的影响。方法选取广东省佛山市第一人民医院2015年5月～2017年5月收治的动脉粥样硬化性非闭塞性肠系膜缺血患者160例，按照随机数字表法分为观察组与对照组，每组80例。对照组患者给予阿托伐他汀治疗，观察组患者在此基础上加用依折麦布治疗。选取年龄及性别相匹配的80名健康志愿者作为健康组。治疗8周后观察三组患者的血脂水平、炎性指标、血管内皮功能并进行比较分析。结果治疗前观察组与对照组总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）水平均高于健康组，高密度脂蛋白胆固醇（HDL-C）水平低于健康组（P ＜ 0.05），观察组与对照组血脂水平比较，差异无统计学意义（P ＞ 0.05）；与治疗前比较，治疗后观察组与对照组TC、LDL-C、TG水平显著降低，且观察组明显低于对照组（P ＜ 0.05），与健康组水平接近；治疗后观察组与对照组HDL-C水平均高于治疗前，观察组升高更明显，差异有统计学意义（P ＜ 0.05）。治疗前，观察组与对照组超敏C反应蛋白（hs-CRP）、基质金属蛋白酶-9（MMP-9）水平均高于健康组，观察组与对照组hs-CRP、MMP-9水平比较，差异无统计学意义（P ＞ 0.05）；治疗后观察组与对照组患者的hs-CRP、MMP-9水平低于治疗前，且观察组明显低于对照组，差异有统计学意义（P ＜ 0.05）。治疗前观察组与对照组一氧化氮（NO）、血管内皮功能（FMD）水平均低于健康组（P ＜ 0.05），观察组与对照组NO、FMD水平比较，差异无统计学意义（P ＞ 0.05）；与治疗前比较，治疗后观察组与对照组患者的NO、FMD水平显著升高，对照组升高更明显，差异有统计学意义（P ＜ 0.05）。治疗后观察组血脂水平、炎性指标、血管内皮功能与健康组比较，差异无统计学意义（P ＞ 0.05）。结论阿托伐他汀联合依折麦布治疗动脉粥样硬化性非闭塞性肠系膜缺血能更有效地调整血脂和降低炎性因子水平，同时可改善血管内皮功能。

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	杨振声1 邱小蕾1 陈颖瑜2 蔡炜标3 刘韶辉4▲

关键词 ：阿托伐他汀, 依折麦布, 肠系膜缺血, 超敏C反应蛋白, 基质金属蛋白酶-9

Abstract：Objective To investigate the clinical effect of Atorvastatin combined with Ezetimibe in the treatment of atherosclerotic non occlusive mesenteric ischemia and its effect on the levels of blood lipid, inflammatory factors, vascular endothelial function. Methods One hundred and sixty patients with atherosclerotic non occlusive mesenteric ischemia from May 2015 to May 2017 in the First People's Hospital of Foshan City were selected and divided into observation group and control group according to random number table method, with 80 cases in each group. The control group was treated with Atorvastatin treatment, on basis of which, the observation group was added with Ezetimibe, and 80 healthy volunteers matched with the other two groups in age and sex were selected as health group. The blood lipid level, inflammation indices, vascular endothelial function of the three groups were compared and analyzed after treatment for 8 weeks. Results Before treatment, the levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) in the observation group and the control group were higher than those in the healthy group (P ＜ 0.05), and the level of high density lipoprotein cholesterol (HDL-C) was lower than that of the healthy group. There was no significant difference between the observation group and the control group (P ＞ 0.05). The levels of TC, LDL-C and TG in the observation group and the control group decreased significantly after treatment. The observation group was significantly lower than the control group (P ＜ 0.05) and close to the level of the healthy group. The levels of HDL-C in the observation group and the control group were higher than those before treatment, and the increase of the observation group was more obvious, the difference was statistically significant (P ＜ 0.05). Before treatment, the levels of hypersensitivity C reaction protein (hs-CRP) and metalloproteinase -9 (MMP-9) in the observation group and the control group were higher than those in the healthy group (P ＜ 0.05). There was no significant difference in the levels of hs-CRP and MMP-9 between the observation group and the control group (P ＞ 0.05). The levels of hs-CRP and MMP-9 in the observation group and the control group were lower than those before treatment, and the level of the observation group was significantly lower than that of the control group, which was significantly lower than the control group, the difference was statistically significant (P ＜ 0.05). Before treatment, the levels of NO and FMD in the observation group and the control group were lower than those in the healthy group(P ＜ 0.05). There were no significant differences in the levels of nitric oxide (NO) and vascular endothelial function (FMD) between the observation group and the control group (P ＞ 0.05). Compared with those before treatment, the levels of NO and FMD in the observation group and the control group were significantly increased, and the control group increased more obviously, the difference was statistically significant (P ＜ 0.05). After treatment, there were no significant differences in blood lipid level, inflammatory markers and vascular endothelial function between the observation group and the healthy group (P ＞ 0.05). Conclusion Atorvastatin combined with Ezemab can reduce the levels of blood lipid, inflammatory factors and improve vascular endothelial function.

Key words： Atorvastatin Ezetimibe Mesenteric ischemia High sensitivity C reactive protein Metalloproteinase-9

基金资助:广东省佛山市卫生和计划生育局医学科研立项课题（20180037）。

通讯作者: ▲通讯作者

引用本文:

杨振声1 邱小蕾1 陈颖瑜2 蔡炜标3 刘韶辉4▲. 阿托伐他汀联合依折麦布治疗动脉粥样硬化性非闭塞性肠系膜缺血的临床效果[J]. 中国医药导报, 2018, 15(17): 127-130.
YANG Zhensheng1 QIU Xiaolei1 CHEN Yingyu2 CAI Weibiao3 LIU Shaohui4▲. Clinical effect of Atorvastatin combined with Ezetimibe in the treatment of atherosclerotic non occlusive mesenteric ischemia. 中国医药导报, 2018, 15(17): 127-130.

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