| Objectives: To observe the influence on carotid intima-media thickness (cIMT) ofthe patients with coronary heart disease (CHD) when ezetimibe combined withatorvastatin calcium or atorvastatin calcium alone, and to observe that phlegm-dissipatingefficacy and safety of drug combination.Methods: Collected65outpatients and inpatients who were diagnosed with CHDand confirmed the presence of CAS by echocardiography in department of Cardiology inDongguan branch of Yan’an University Affiliated Hospital from2012.5to2013.10.Allthe65patients met the inclusion criteria, did not meet the exclusion criteria. Inclusioncriteria:①aged40-80years old, male or female.②diagnosed with CHD andconfirmed the presence of CAS by ultrasound.③had not taken over other types of lipidregulating drugs before entering the group.④compliance was good and could reviewthe relevant checks.⑤patients signed informed consent. Exclusion criteria:①had usedother types of lipid drug before entering the group.②o lder than80years old.③hadsevere liver disease, gastrointestinal disease, any type of cancer, various types of diabetes,hypertensive disease, etc.④alanine aminotransferase and aspartate aminotransferasemore than twice the normal maximum of abnormal liver function.⑤the patients whocould not cope with the review.⑥pregnant and lactating women.⑦the patients in otherclinical trials recently.⑧other cases unsuitable for enrolled. According to the principle ofrandomization and the table of random numbers, all patients were divided into two groups: combined treatment group had a total of31cases,13males and18females,mean age (61±9) years old; alone treatment group had a total of34cases,18males,16females, mean age (64±8) years old. each group of patients were used anti-plateletaggregation, improve circulation and other conventional treatment. In combinedtreatment group,20mg of atorvastatin combined with10mg ezetimibe oral1time/d, for24consecutive weeks; alone treatment group20mg of atorvastatin calcium oral1time/d,for24consecutive weeks. Before treatment,12weeks and24weeks for patients with thefollowing tests: serum total cholesterol (TC), triglyceride (TG), LDL cholesterol(LDL-C), high lipoprotein cholesterol (HDL-C) levels, carotid artery intima-mediathickness (cIMT). Other laboratory tests: blood routine, blood glucose, muscle enzymes,liver function, kidney function, electrolytes, etc. Statistical analysis: SPASS17.0statistical software was used for analysis, measurement data was expressed as mean±standard deviation, compared with values before and after the treatment of the samesample detection, using the paired t test, compared with test values between the twosamples before and after treatment, using independent sample t test, if the general doesnot obey normal distribution, it must be tested by the non-parameter test; count datausing the number of cases (frequency) that the X2test was used to compare rates. ResultsP <0.05indicated a statistically significant difference, P>0.05indicates no significantdifference.Results:1、Both groups selected patients at gender,an average age,the severity of diseaseand related drugs such as application before admission, the difference was notstatistically significant after analysis(P>0.05).2、Both groups of patients with cIMT detection index，compared after treatment atthe12th week and the24th week with before treatment, compared the24th week withthe12th week after treatment，the difference was statistically significant (P<0.05);compared combined treatment group of patients with cIMT detection index aftertreatment with alone treatment group of that at the24th week and the12th week, thedifference was statistically significant (P<0.05).3、Both groups of patients with TC, TG, LDL-C detection index，compared aftertreatment at the12th week and the24th week with before treatment, compared the24th week with the12th week after treatment，the difference was statistically significant(P<0.05);compared combined treatment group of patients with TC, TG, LDL-C detectionindex after treatment with alone treatment group of that at the24th week and the12thweek, the difference was statistically significant (P<0.05).4、Both groups of patients with LDL-C standard rate，compared after treatment atthe12th week and the24th week with before treatment, compared the24th week withthe12th week after treatment，the difference was statistically significant (P<0.05)，compared combined treatment group of patients with LDL-C standard rate with alonetreatment group of that at the24th week and the12th week, the difference wasstatistically significant (P<0.05).The patients in combined treatment group had thehighest LDL-C standard rate after24weeks treatment.5、Combined treatment group of patients of common adverse reactions was9.68%in the treatment of24weeks，alone treatment group of patients of common adversereactions was11.76%in the treatment of24weeks. compared the incidence of adversereactions in both groups of patients, the difference was not statistically significant (P>0.05).Conclusions:1、Combined treatment and alone treatment long-term use all can improve the CHDof patients with cIMT, but combined treatment effect is better than that of alone treatment,two were ultimately failed to make the plaque dissipated.2、 Combined treatment and alone treatment can effectively lower blood lipid levelsin patients with CHD, but hypolipidemic effect of combined treatment is better thanalone treatment.3、Both kinds of treatment show that：the longer course of treatment is， the higherLDL-C compliance rate is, compliance rate of LDL-C after24weeks of treatment ishigher in combined treatment than alone treatment.4、Both kinds of treatment have good tolerability and safety, common adversereaction of combined treatment does not increase. |
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