不同剂量瑞舒伐他汀对老年冠心病患者疗效及安全性观察  

Efficacy and Safety of Different Doses of Rosuvastatin in Treatment of Elderly Coronary Heart Disease Patients

作　　者：岳福伟 魏子秀[2] 徐勤成[2] 田飞飞[2] 孙晓斐[2] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,山东济南250000 [2]山东省医学科学院附属济宁市第一人民医院,山东济宁272000

出　　处：《现代生物医学进展》2015年第10期1888-1890,1898,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨不同剂量的瑞舒伐他汀对老年冠心病患者的疗效及安全性的影响。方法:抽取2012年6月至2013年6月于我院住院行冠脉造影检查示冠状动脉临界病变,诊断为冠状动脉粥样硬化性心脏病的患者210例(≥75岁),随机分为甲组,乙组,对甲组给予10 mg/d的瑞舒伐他汀药物口服治疗,乙组给予20 mg/d的瑞舒伐他汀药物口服治疗,其它协同药物服用方法均采集。收集患者开始服用瑞舒伐他汀药物前及服用后1月、6月、12月的血生化指标及颈动脉彩超结果,包括低密度脂蛋白胆固醇(Low-density Lipoprotein Cholesterol,LDL-C),总胆固醇(Total Cholesterol,TC),甘油三脂(Triglyceride,TG),高密度脂蛋白胆固醇(High-density Lipoprotein Cholesterol,HDL-C),超敏C反应蛋白(High Sensitivity C Reactive Protein,hs-CRP),颈动脉内-中膜厚度(Intima-media thickness,IMT),谷丙转氨酶(Alanine-Aminotransferase,ALT),观察这些指标服药前后变化的情况。结果:瑞舒伐他汀药物治疗1月、6月、12月后两组患者指标相比较,乙组患者较甲组患者TC、TG、LDL-C、hs-CRP、IMT降低更明显,而HDL-C升高水平则明显高于甲组,差别有统计学意义(P<0.05)。两组患者之间血生化指标ALT及药物治疗期间发生瑞舒伐他汀相关严重不良反应例数,无明显差别(P>0.05)。两组均无因心脏不良事件(MACE事件)而终止实验的患者。结论:对于老年冠心病患者,瑞舒伐他汀药物治疗可以获益,高强度的瑞舒伐他汀药物获益更显著,并且是安全的。Objective： To explore the efficacy and safety of different doses of rosuvastatin in treatment of elderly coronary heart disease patients. Methods： Two hundred and ten hospitalized patients（including 75 years old and higher） diagnosed as Coronary atherosclerotic cardiopathy（ CHD） were evenly divided into group A and group B by random from June 2012 to June 2013. The patients in group A were treated with oral rosuvastatin at the dose of 10 mg/d, and the patients in group B were treated with oral rosuvastatin at the dose of 20 mg/d. The other cooperative medication methods were collected. Biochemical indicators were measured before and after one, six, twelve months of treatment, including Low-density Lipoprotein Cholesterol（LDL-C）, Total Cholesterol（TC）, High Sensitivity C Reactive Protein（hs-CRP）, Triglyceride（TG）, High-density Lipoprotein Cholesterol（HDL-C）, Alanine-Aminotransferase（ALT）, and Intima-media thickness（IMT）. Result： There were significant decrease in LDL-C, TC, hs-CRP, and TG between the two groups before and after one, six, and twelve months of treatment（P0.05）. After treatment, the levels of LDL-C, TC, TG, and hs-CRP of group B were significantly lower than that of group A（P 0.05）, and HDL-C higher level was significantly higher than in group A. There was no significant difference between the two groups in the level of ALT and the incidences of adverse reactions（P0.05）. Both group A and group B had no adverse cardiac events（MACE） and termination of the experiments. Conclusion： For elderly patients with coronary heart disease in our country, rosuvastatin medication is beneficial, and higher dose of rosuvastatin is safe and more effective against CHD.

关 键 词：冠心病 瑞舒伐他汀 低密度脂蛋白胆固醇 总胆固醇 颈动脉内-中膜厚度 

分 类 号：R541.4[医药卫生—心血管疾病]