老老年急性冠状动脉综合征患者阿托伐他汀联合依折麦布对比双倍剂量阿托伐他汀疗效研究  

Effect of combined atorvastatin and ezetimibe compared to that of double-dose atorvastatin in very old patients with ACS

作　　者：刘志[1] 李静[1] 高敬[1] 范振兴[1] 王艳玲[1] 谭静[1] 华琦[1] 

机构地区：[1]首都医科大学寅武医院心脏科,北京100053

出　　处：《中华老年心脑血管病杂志》2017年第1期5-8,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨不同调脂治疗方案对老老年急性冠状动脉综合征(ACS)患者的疗效。方法连续选择2012年6月~2014年6月于我院心脏科166例确诊为ACS的患者进行前瞻性随机对照试验,其中男性86例,女性80例,年龄80~88(83.8±2.3)岁,随机分为联合治疗组84例(阿托伐他汀10mg/d+依折麦布10mg/d)和双倍剂量组82例(阿托伐他汀20mg/d)。随访1年观察2组患者的终点事件。结果随访3个月时,联合治疗组高敏C反应蛋白水平明显高于双倍剂量组[(2.5±1.4)mg/L vs(2.1±1.5)mg/L,P=0.033],随访1年2组患者主要不良心血管事件,无统计学差异(23.8%vs 19.0%,P=0.473)。随访终点,2组患者在主要不良心血管事件(心源性死亡、非致死性心肌梗死、再血管化治疗)、脑卒中和肌痛/肌无力等方面比较,差异无统计学意义(P>0.05)。Cox分析表明,联合治疗组患者心血管风险与双倍剂量组患者无明显差异(HR=1.12,95%CI:0.51~2.55,P=0.743)。结论对于老老年ACS患者,阿托伐他汀联合依折麦布可以取得与双倍剂量阿托伐他汀治疗近似的长期预后。Objective To compare the effect of different lipid-lowering therapies in very old patients with acute coronary syndrome（ACS）.Methods One hundred and sixty-six ACS patients（86males and 80females）aged 80-88（83.8±2.3）years admitted to our hospital from June2012 to June 2014 were randomly divided into combined atorvastatin（10mg/d）and ezetimibe（10mg/d）treatment group（n=84）and double-dose atorvastatin（20 mg/d）treatment group（n=82）.The patients were followed up for one year during which their primary end points were recorded.Results The serum hs-CRP level was significantly higher in combined atorvastatin and ezetimibe treatment group than in double-dose atorvastatin treatment group by the end of3-month follow-up period（2.5±1.4mg/L vs 2.1±1.5mg/L,P=0.033）.No significant difference was found in the incidence of major adverse cardiovascular events（MACE）between the two groups by the end of one year follow-up period（23.8% vs 19.0%,P=0.473）.No significant difference was found in MACE（cardiogenic death,non-lethal myocardial infarction,revascularization therapy）,ischemic stroke,myalgia,myasthenia,etc（P 0.05）.Cox regression analysis showed no significant difference in the risk of MACE between the two groups（HR=1.12,95%CI：0.51-2.55,P=0.743）.Conclusion The long-term effect of combined atorvastatin and ezetimibe and double-dose atorvastatin is similar in very old ACS patients.

关 键 词：急性冠状动脉综合征 降血脂药 药物疗法 联合 C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病]