辛伐他汀在老年急性冠状动脉综合征早期应用的安全性及有效性  

Efficacy and safety of early treatment with simvastatin in aged patients with acute coronary syndrome

作　　者：葛晓娟[1] 关振龙 刘蔚[3] 马觉民[4] 

机构地区：[1]辽宁阜新市中心医院内科,辽宁阜新123000 [2]辽宁阜新市肿瘤医院 [3]卫生部北京医院 [4]广西柳州市人民医院

出　　处：《临床心血管病杂志》2006年第4期203-205,共3页Journal of Clinical Cardiology

摘　　要：目的:观察老年急性冠状动脉综合征(ACS)发病早期应用不同剂量的辛伐他汀的临床疗效及安全性。方法:选择临床确诊为ACS的患者共117例,均总胆固醇(TC)≥4.68mmol/L和(或)低密度脂蛋白胆固醇(LDLC)≥2.6mmol/L,年龄62～79岁。入院48h内空腹采静脉血测定血脂等生化指标及高敏C反应蛋白(hsCRP),将患者随机分为20mg组(A组,58例)和40mg组(B组,59例),均为每晚服药1次,分别于用药前,用药后4、12周测定TC、LDLC、高密度脂蛋白胆固醇、三酰甘油及hsCRP,随访3个月内所有不良反应,观察终点为心脏事件的发生率。结果:①2组服药后4、12周的TC、LDLC、hsCRP水平均较治疗前明显降低(P<0.05),B组较A组降低更明显,P<0.05;②B组累计心脏事件发生率较A组明显减少(P<0.05);③2组均无严重不良反应。结论:ACS患者早期应用辛伐他汀40mg/d,能更有效地降脂,提高达标率,明显抑制炎症因子,减少住院率及心脏血管事件的发生率,且安全、耐受性好。Objectives：To observe the clinical effects and safety of early treatment with different doses of simvastatin in aged patients with acute coronary syndrome（ACS）. Method： One hundred and seventeen patients with ACS,aged from 62 to 79 years, accompanied by the total cholesterol （TC） no less than 4.68 mmol · L^-1 and/or low-density lipoprotein （ LDL）no less than 2.6 mmol · L^-1 , were randomly divided into 2 groups., group A （ n = 58, administrated simvastatin 20 mg· d^-1 in the evening）, group B （ n = 59, administrated simvastatin 40 mg· d^-1 in the evening）. The levels of blood triglycerides （TC）, LDL, high-density lipoprotein （ HDL）, TG, and high sensitivity C-reactive protein （hsCRP） were all detected before and after 1 month, 3 months of the treatment. All adverse reaction in 3 months were followed up. The primary ending point is the incidence of cardiovascular disease. Result： After 1 month or 3 months of the treatment, the levels of blood TC, LDL, HDL, TG,and hsCRP in both of the 2 groups were decreased significantly than those before the treatment, especially in group B, P 〈0. 05. During the follow-up the incidence of cardiac events in group B was less than that in group A markedly, P 〈0. 05. No severe adverce effects were found in these 2 groups in the experiment. Conclusion：Early treatment with simvastatin 40 mg · d^-1 had a good effect in lowing blood lipid, inhibiting the product of inflammatory factors and reducing the incidence of cardiac events, thus it was safe in the patients with ACS.

关 键 词：急性冠状动脉综合征 辛伐他汀 降血脂药 老年人 

分 类 号：R542.2[医药卫生—心血管疾病]