不同剂量降脂药物在不稳定型心绞痛非血运重建老年患者中的临床疗效  

Different doses of atorvastatin calcium for elderly patients with unstable angina pectoris and non-revascularization

作　　者：马建新[1] 何永锋[2] 宋成运[1] 李运田[1] 许玉韵[3] 

机构地区：[1]解放军第305医院心脏中心,北京100017 [2]中共中央文献研究室医务室内科,北京100017 [3]北京大学第一医院心内科,北京100034

出　　处：《中华老年多器官疾病杂志》2012年第8期604-608,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的观察不稳定型心绞痛（UA）非血运重建老年患者应用不同剂量阿托伐他汀钙的疗效与安全性。方法uA非血运重建老年患者38例。随机分为两组，分别给予阿托伐他汀钙20mg／d与40mg／d，每晚1次，用药3个月，观察两组患者血脂达标情况、动态心电图结果、主要心血管事件（MACE）及不良反应发生情况。结果两组患者总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均明显下降（P〈0．05）。与20mg／d组相比，40mg／d治疗1个月缺血性ST段下降的程度明显减少（P〈0．05），非致死性心肌梗死、复发心绞痛及因症状性心肌缺血再住院等主要心血管事件发生率显著降低（P〈0．05）。药物不良反应事件发生率两组比较无统计学意义（P〉0．05）。结论UA非血运重建老年患者应用20mg／d及40mg／d的阿托伐他汀钙均能有效调脂，40mg／d的阿托伐他汀钙可提高疗效，能更有效地降低主要心血管事件发生率，且无明显不良反应。Objective To observe the safety and effectiveness of different doses of atorvastatin calcium for patients with unstable angina pectoris （UA） and non-revascularization. Methods Thirty-eight elderly patients with UA and non-revascularization were randomly divided into 2 groups. One group received atorvastatin calcium 20mg daily, the other group 40mg instead. Total cholesterol（TC）, triglyceride （TG）, low-density lipoprotein cholesterol（LDL-C） and lipid profiles were measured at 1 and 3 months, as well as Holter examination results, main adverse cardiac events（ MACE ） and adverse drug reaction. Results After treatment, TC, TG and LDL-C in two groups were significantly reduced （P 〈 0.05）. Compared with 20mg group, both the degree and the duration of ischemic ST segment depression were significantly decreased （P 〈 0.05）, and the incidence of MACE, including nonfatal myocardial infarction, recurrent angina pectoris and rehospitalization due to symptomatic myocardial ischemia, was significantly lower in 40mg group （P 〈 0.05）. There was no significant difference in the incidence of adverse drug reaction between the two groups （P 〉 0.05）. Conclusion For elderly patients with UA and non-revascularization, atorvastatin calcium both the dose 20mg/d and 40mg/d can regulate effectively the blood lipid profiles. Atorvastatin calcium at the dose of 40mg/d has more significant effectiveness.

关 键 词：不稳定型心绞痛 非血运重建 阿托伐他汀钙 

分 类 号：R541.6[医药卫生—心血管疾病]