中文摘要：

目的探讨急性冠脉综合征（ACS）合并2型糖尿病（T2DM）患者早期联合降脂治疗对血脂、炎症指标的影响，并评价其安全性。方法ACS合并T2DM的患者84例，其中他汀单药治疗（他汀单药组）40例，他汀联合依折麦布治疗（联合治疗组）44例。随访1个月，观察血脂、超敏C反应蛋白、肝功、肾功及肌酶等。结果联合治疗组和他汀单药组7d后的低密度脂蛋白胆固醇（LDL—C）水平分别为（1．87±0．42）和（2．18±0．58）mmol／L（P=0．007），30d后分别为（1．51±0．29）和（1．94±0．49）mmol／L（P〈0．001）；以LDL．C水平降至1．8mmol／L或下降50％来计算达标率，30d后联合治疗组达标率显著优于他汀单药组（77％和45％，P=0．002）。治疗30d后，2组高密度脂蛋白胆固醇水平较基线水平均未见改善，甘油三酯水平和超敏C反应蛋白水平显著降低，但2组间无明显差异，且超敏c反应蛋白水平与血脂水平无相关性。2组在治疗过程中均未发现肝酶升高、肌病等不良反应。结论对于ACS合并T2DM患者在初始治疗时即可予依折麦布联合常规剂量他汀治疗，可在短时间内更大幅度的降低LDL—C，有效提高LDL—C达标率，且安全性良好．

英文摘要：

Objective To evaluate the effects and safety of combined use of ezetimibe with standard dose of statins in patients with both acute coro- nary syndrome （ACS） and type 2 diabetes mellitus （T2DM）. Methods Patients with both ACS and T2DM were randomly divided into the stan- dard dose group of statins （ n = 40） and the combination therapy group of ezetimibe and statins （ n = 44）. In order to evaluate the clinical effects on lowering lipids, systemic inflammation response and clinical safety, follow up was carried out on day 7 and day 30. Results The level of low-density lipoprotein cholesterol （LDL-C ） in combination group and statins group are 1.87±0.42 vs 2.18± 0.58 mmol/L （P = 0.007） on day 7, and 1.51± 0.29 vs 1.94± 0.49 mmol/L （ P 〈 0.001 ） on day 30. Based on the guideline target of LDL-C reduction 〉50% or LDL-C level ≤ 1.8 retool/L, the con- trol rate of the combination group and the standard dose group of statins were 77% and 45% （P = 0.002 ）, respectively. On day 30, there was no sig- nificant improvement in high-density lipoprotein cholesterol in both groups, neither significant difference of triglyceride level nor high-sensitivity C- reactive protein （hs-CRP） level between two groups. No correlation exists between improvement of serum-lipid level and hs-CRP level. Conclusion Our study demonstrated that it is feasible to initiate combination therapy during acute phase for patients with both ACS and T2DM, which can bring more significant effects of lowering LDL-C with a good safety.