目的 观察阿托伐他联合依折麦布治疗冠状动脉粥样硬化性心脏病（冠心病）合并高脂血症对不对称二甲基精氨酸（ADMA）、趋化因子fractalkine（CX3CL1）的影响，为临床治疗提供参考。方法 选取2018年1月至2020年5月于北京协和医院心内科收治的冠心病伴高脂血症患者120例，根据用药不同分为对照组（阿托伐他汀片治疗）和观察组（对照组联合依折麦布片），每组各60例。检测两组治疗前后ADMA、CX3CL1、炎症因子、血脂的变化，并统计两组临床治疗总有效率。结果 观察组总有效率高于对照组（91.67% vs. 78.33%），差异具有统计学意义（P＜0.05）。治疗后两组高密度脂蛋白胆固醇（HDL-C）较前升高，ADMA、CX3CL1、低密度脂蛋白胆固醇（LDL-C）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、单核细胞趋化蛋白1（MCP-1）、总胆固醇（TC）、三酰甘油（TG）降低，（P＜0.05），组间比较发现，观察组ADMA、CX3CL1、血脂指标（HDL-C除外）、炎症因子均低于对照组，HDL-C高于对照组（P＜0.05）。结论 阿托伐他汀片联合依折麦布片治疗冠心病合并高脂血症可改善血脂，降低ADMA、CX3CL1的表达，减轻炎症反应，提高临床疗效。

Objective To observe the influence of atorvastatin (ATV) combined with ezetimibe on asymmetric dimethylarginine (ADMA) and chemokine fractalkine (CX3CL1) in treatment of coronary heart disease (CHD) complicated by hyperlipidemia, and provide reference for clinical practice. Methods The patients (n=120) were chosen from Department of Cardiology in Peking Union Medical College Hospital from Jan. 2018 to May 2020, and divided into control group (treated with ATV) and observation group (treated with ATV combined with ezetimibe, each n=60). The changes of ADMA, CX3CL1, inflammatory factors and blood fat were detected, and the total effective rate was observed in 2 groups before and after treatment. Results The total effective rate was higher in observation group than that in control group (91.67% vs. 78.33%, P<0.05). After treatment, the level of high-density lipoproteincholesterol (HDL-C) increased, and levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), total cholesterol (TC) and triacylglycerol (TG) decreased in 2 groups (P<0.05). The comparison between groups showed that ADMA, CX3CL1 and blood fat indexes (except of HDL-C) and inflammatory factors were lower, and HDL-C was higher in observation group than those in control group (P<0.05). Conclusion ATV combined with ezetimibe can improve blood fat condition, reduce the expressions of ADMA and CX3CL1, relieve inflammatory reactions and promote clinical efficacy in treatment of CHD complicated by hyperlipidemia.