依泽替米贝对高脂血症致老年血管内皮功能破坏的作用及机制探讨

发布时间：2018-06-29 01:06

本文选题：依泽替米贝 + 高脂血症　；参考：《重庆医学》2016年19期

【摘要】：目的观察依泽替米贝对高脂血症(HLP)致老年血管内皮功能破坏的影响,以及对血清氧化型低密度脂蛋白(oxLDL),凝集素样氧化低密度脂蛋白受体-1(LOX-1)和脂联素(APN)的影响。方法选择符合条件的原发性HLP患者90例,疗程期间失访2例,共88例纳入研究,按随机数字表法分为观察组与对照组,各44例;两组均采取常规降血压药治疗,观察组加用依泽替米贝内服治疗,每次10mg,每日1次。疗程期间两组患者均给予健康指导,均连续治疗24周;比较两组治疗前后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平,以及肱动脉血管内皮依赖性舒张功能(FMD)、非依赖性血管内皮舒张功能(NMD)和颈动脉内膜中层厚度(IMT)的变化情况;检测两组治疗前后血清ox-LDL、LOX-1和APN水平。结果治疗后观察组患者TC、TG和LDL-C水平均低于对照组,HDL-C水平高于对照组(P0.01或P0.05);观察组总有效率(93.18%)优于对照组(75.00%),差异有统计学意义(P0.05);观察组治疗后FMD和NMD均高于对照组,IMT低于对照组,差异均有统计学意义(P0.01);治疗后,观察组血清ox-LDL和LOX-1水平低于对照组,而APN水平高于对照组,差异均有统计学意义(P0.01)。结论老年HLP患者在常规降压治疗基础上采取依泽替米贝治疗可明显改善脂质代谢紊乱和血管内皮功能,提高临床疗效,其降低血清ox-LDL、LOX-1水平和提高APN水平,可能是发挥上述作用的机制之一。
[Abstract]:Objective to observe the effects of Ezetimibe on endothelial dysfunction induced by hyperlipidemia (HLP) and on serum oxidized low density lipoprotein (oxLDL), lectin-like oxidized low density lipoprotein receptor 1 (LOX-1) and adiponectin (APN). Methods Eighty-eight patients with primary HLP were divided into two groups according to the random digital table method: observation group (n = 44) and control group (n = 44). Both groups were treated with conventional antihypertensive drugs. The observation group was treated with Ezetimibe orally, 10 mg a time, once a day. During the course of treatment, the patients in both groups were given health guidance and were treated continuously for 24 weeks, the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared before and after treatment. The changes of endothelium-dependent diastolic function (FMD), endothelium-independent diastolic function (NMD) and carotid intima-media thickness (IMT) of brachial artery were measured before and after treatment. Results after treatment, the levels of TCTG and LDL-C in the observation group were lower than those in the control group (P0.01 or P0.05), the total effective rate (93.18%) in the observation group was better than that in the control group (75.00%), the difference was statistically significant (P0.05). After treatment, the levels of serum ox-LDL and LOX-1 in the observation group were lower than those in the control group, while APN levels were higher than those in the control group (P0.01). Conclusion Ezetimibe on the basis of conventional hypotensive therapy in elderly patients with HLP can significantly improve lipid metabolism disorder, vascular endothelial function and clinical efficacy. It can reduce the level of serum ox-LDLL LOX-1 and increase the level of APN. May be one of the mechanisms to play this role.
【作者单位】：江西省人民医院老年科;江西省人民医院药剂科;
【分类号】：R589.2

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