目的 探讨依折麦布联合阿托伐他汀治疗高胆固醇血症患者的效果及对血浆脂蛋白磷脂酶A2（Lp-PLA2）水平的影响。方法 选取东莞市第五人民医院确诊的高胆固醇血症患者300例，病例收集时间2017年1月-2017年6月，采用随机数字表法分为联合组（阿托伐他汀20 mg/d+依折麦布10 mg/d）、他汀组（阿托伐他汀20 mg/d）各150例，连续治疗3个月，检测并对比两组治疗前后的血脂水平和Lp-PLA2。结果 治疗前，联合组和他汀组患者的血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、Lp-PLA2水平差异均无统计学意义；两组患者治疗后的血清TC、TG、LDL-C、Lp-PLA水平较治疗前均显著的降低，HDL-C水平较治疗前显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，联合组患者的血清TC、TG、LDL-C、Lp-PLA2水平较他汀组显著降低，差异有统计学意义（P<0.05）。治疗后，联合组患者显效率为80.00%，总有效率为96.67%，他汀组显效率为69.33%，总有效率为91.33%，两组比较差异具有统计学意义（P<0.05）。联合组患者不良反应发生率8.67%，与他汀组的6.00%比较，差异无统计学意义。结论 依折麦布联合阿托伐他汀治疗高胆固醇血症患者的效果优于单纯使用他汀类药物治疗，并且对血浆LpPLA2水平具有很好的改善作用。

Objective To investigate the effect of atorvastatin combined with ezetimibe on patients with hypercholesterolemia and the effect on plasma Lp-PLA2 levels. Methods 300 cases of hypercholesterolemia diagnosed by the Fifth People's Hospital of Dongguan City were selected. The case collection time was from January 2017 to June 2017. Randomized digital table method was divided into a combination group (atorvastatin 20 mg/d + ezetimibe 10 mg/d), statin group (atorvastatin 20 mg/d) 150 cases each, continuous treatment for 3 months to observe the two groups Clinical effects. Results There were no significant differences in serum TC, TG, HDL-C, LDL-C, and Lp-PLA2 levels between the combination group and the statin group before treatment. The levels of serum TC, TG, HDL-C, LDL-C and Lp-PLA in the two groups were significantly lower than those in the group before treatment. The difference between the two groups was statistically significant (P<0.05). After treatment, the serum levels of TC, TG, LDL-C, and Lp-PLA2 in the combination group were significantly lower than those in the statin group, and the difference was statistically significant (P<0.05). After treatment, the marked effective of combined group was 80%, total effective was 96.67%, and marked effect of statin group was 69.33%, total effective was 91.33%, the difference between the two groups was statistically significant (P<0.05). The incidence of adverse reactions in the combined group was 8.67%, which was not statistically significant compared with 6% in the statin group. Conclusion Atovastantin combined with ezetimibe is better than statins alone in the treatment of hypercholesterolemia, and has a good improvement in plasma Lp-PLA2 levels.

R969

东莞市社会科技发展一般项目（201650715001259）