Efficacy Of Pivastatin Combined With Ezetimibe In The Treatment Of Elderly Patients With Hypercholesterolemia And Carotid Atherosclerosis

Hypercholesterolemia is a common internal medical disease,which is one of the risk factors leading to cardiovascular and cerebrovascular diseases.In recent years,the current situation of lipid management in China suggests that although most of the patients had good lipid-lowering effect with conventional dosage of statins,some patients’ lipid levels did not decrease further as the dosage increased.Comparison of statins and ezetimibe can further lowered the level of blood cholesterol and the side effect caused by large dosage of statins can be reduced.By delaying or reversing the occurrence and development of atherosclerosis,the occurrence of related cardiovascular and cerebrovascular events can by reduced.Objective: To evaluate the clinical efficacy of pivastatin 2 mg/d combined with ezetimibe 10 mg/d and pivastatin 2 mg/d alone in the treatment of senile hypercholesterolemia and carotid atherosclerosis through clinical follow-up observation of elderly patients with carotid atherosclerosis.Methods: Choose 96 elderly patients with hypercholesterolemia and carotid atherosclerosis plaque randomized to two groups: observation group(pivastatin 2 mg/d +ezetimibe 10 mg/d,n=49)and control group(pivastatin 2 mg/d,n=47).The patients were followed up for 6 months.At the beginning and the end of the course of treatment,all patients tested the total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),intima-media thickness(IMT)and plaque area(Smax).During treatment,the adverse drug reactions(ADRs)and cardiovascular adverse events were monitored,such as aspartate aminotransferase(AST),alanine aminotransferase(ALT),creatine kinase(CK).The data obtained were made further analysis by SPSS20.0 statistical package.Results:(1)The baseline clinical data of the two groups were compared.There were no significant differences in the clinical characteristics such as gender,body mass index,smoking history,diabetes mellitus and hypertension between the two groups(P>0.05).(2)There was no significant difference in blood lipid levels between the two groupsbefore treatment(P>0.05).After treatment,TC,TG,LDL-C in the two groups were significantly lower than before,HDL-C was slightly higher than before treatment(P>0.05);compared with the two groups after treatment,TC,TG,LDL-C in the observation group were significantly lower than those in the control group(P<0.05),there was no significant difference in HDL-C between the two groups(P>0.05).The blood lipid compliance rates of the two groups were 81.63% in the observation group and 65.96% in the control group respectively.The difference was statistically significant(P < 0.05).(3)There was no significant difference in IMT and carotid atherosclerotic plaque area between the two groups before treatment(P>0.05).After 6 months of treatment,IMT in the two groups decreased slightly compared with that before treatment,but there was no significant difference between the two groups before and after treatment(P>0.05).After treatment,carotid atherosclerotic plaque area in the two groups were significantly decreased than before treatment(P<0.05).Compared the two groups after treatment,the improvement of the carotid atherosclerotic plaque area in the observation group was more significant than that in the control group(P<0.05).(4)During the grouping treatment,there was no difference in the incidence of adverse drug reactions between the two groups(P>0.05),and there was no significant difference in the incidence of MACE events between the two groups(P>0.05).Conclusion: Comparing with the therapeutic effects of pivastatin 2mg/d and pivastatin2mg/d+ezetimibe 10mg/d on carotid atherosclerosis in elderly hypercholesterolemic patients,(1)the combination of pivastatin 2mg/d+ezetimibe 10mg/d can reduce the blood lipid level of elderly patients with hypercholesterolemia more effectively;(2)the combination of pivastatin2mg/d+ezetimibe 10mg/d can further improve the occurrence and development of carotid atherosclerosis plaque;(3)the combination of pivastatin 2mg/d+ezetimibe 10mg/d and pivastatin 2mg/d are all safe and effective.No serious adverse drug reactions and cardiovascular events occurred.