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Objective:By discuss zhibitai combined with atorvastatin 10mg and only use atorvastatin 20mg or atorvastatin 40mg, we well evaluate the clinical lipid-lowering, anti-inflammatory effect and clinical app-lication security of zhibitai combined with atorvastatin 10mg by comparing the lipid-lowering effects of observed in each group myo-cardial inflammatory factors of carditrophin-1 (CT-1),high sen-sitivity creactive protein (hs-CRP) and adverse effects in patients with coronary heart disease.The result will provide clinical reference applications and provide new ideas and strategies for zhibitai combined with atorvastatin in coronary heart diseaseMethods:150 patients with clinical diagnostic criteria for coronary heart disease patients, all patients were divided into 3 groups under medical treatment in the basic randomized. Group 1 to zhibitai 480 mg, orally twice daily+atorvastatin calcium 10mg, taken a half an hour before going to bed every night, once every 8 weeks, once every 8 weeks; 2 groups to atorvastatin calcium 20mg taken a half an hour before going to bed every night, once every 8 weeks, once every 8 weeks; 3 groups to atorvastatin calcium 40mg orally, taken a half an hour before going to bed every night, once every 8 weeks.Basic medical treatment means:all entry groups to give patients with coronary heart disease based on the following drugs:angioten-sin converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB), calcium channel blockers (CCB), Clopidogrel, Aspirin,βblockers, Zhixinkang tablets (isosorbide mononitrate tablets) and other appropriate blood pressure, glucose and other treat ment.All patients test the concentration of CT-1 and hs-CRP in the serum separating from venous blood in before treatment, after 4 weeks and after 8 weeks.All patients test the lipoprotein profile:triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein choles-terol (LDL-C), apolipoprotein A1 (ApoA1) and apolipoprotein B100(ApoB100).Simultaneous test liver function:alanine aminotransferase (ALT), aspartate amino trans-ferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL); renal function:urea ni-trogen (BUN), creatinine (Cr); muscle enzymes: creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), troponin (aTn-I), myoglobin (MYO) in the serum separating from venous blood in before treatment, after 4 weeks and after 8 weeks.All patients test 12-lead electrocardio-gram (ECG) examina-tion after hospitalization.Results:1、compared with before treatment, the levels of TC, LDL-C, ApoB100 in three groups were significantly decreased after 4 weeks and 8 weeks (all P<0.01). Zhibitai+atorvastatin 100mg group and atorvastatin 40mg group have similar efficacy, both groups had slight advantage than atorvastatin 20mg group,but no significant difference between the two groups (P> 0.05).2、compared with before treatment, the levels of TG in three groups of patients were decreased, zhibitai+ atorvastatin 10mg group and atorvastatin 40mg group decreased more significantly than atorvas-tatin 20mg group, atorvastatin 20mg group had no significant decrease after treatment 4 weeks (P> 0.05), after 8 weeks treatment decreased significantly (P<0.01), no significant difference between the three groups after treatmeat for 8 weeks. (P> 0.05)3、compared with before treatment, the levels of HDL-C and ApoA1 in three groups of patients were increased after 4 weeks and 8 weeks, but no significant differences (all P> 0.05), no difference between the three groups (P> 0.05).4、compared with before treatment, the levels of CT-1 and hs-CRP were significantly decreased in three groups of patients treated for after 4 weeks and 8 weeks (P<0.01), zhibitai+ atorvastatin 10mg group and atorvastatin 40mg group decreased more significantly than atorvastatin 20mg group, no significant difference between the three groups (P> 0.05).5、compared with before treatment, the levels of liver function, kidney function, the incidence of myopathy, muscle enzyme increased incidence and gastrointestinal adverse reactions in three groups of patients was no significant difference in the incidence rate after treated 4 weeks and 8 weeks (P> 0.05), no significant differen-ce between the three groups (P> 0.05).Conclusion:Zhibitai combined with atorvastatin lOmg in patients with coronary heart disease can be significantly reduced TG, TC, LDL-C, ApoB100 level, slightly elevated HDL-C, ApoA1 levels and significantly reduce the inflammatory cytokines CT-1, hs-CRP levels, efficacy and similar atorvastatin 40mg, atorvastatin 20mg compared with more advantages and fewer side effects, clinical application security, is expected to become the new trend for future lipid-lowering therapy.
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