他汀类药物干预飞行人员冠状动脉粥样硬化的疗效观察  

Effect of statins therapy on flight crew with coronary atherosclerosis

作　　者：陈诗婷[1] 孙津津[1] 司冰心[2] 殷雪娇[1] 牟宗阳 罗惠兰[4] CHEN Shiting SUN linjin SI Bingxin YIN Xuejiao MOU Zongyang LUO Huilan(Department of Cardiology, Air Force General Hospital, Beijing 100142, China)

机构地区：[1]空军总医院心脏中心内科,北京100142 [2]空军总医院保健办公室,北京100142 [3]贵州医科大学,贵阳550004 [4]空军总医院干部病房六区,北京100142

出　　处：《空军医学杂志》2017年第3期149-152,共4页Medical Journal of Air Force

基　　金：全军"十二五"重点课题(BWS11J054)

摘　　要：目的评价他汀类药物治疗飞行人员冠状动脉粥样硬化的疗效。方法选择冠状动脉粥样硬化的飞行人员21例,均给予他汀类药物强化降脂治疗,观察2年后,复查冠状动脉造影(coronary angiography,CAG)检查评估冠状动脉狭窄情况,监测治疗期间他汀类药物的不良反应,观察他汀类药物治疗前后的血脂水平、心血管疾病(cardiovascular disease,CVD)发病风险和冠状动脉的狭窄程度的变化。结果 (1)治疗后低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)均明显下降,高密度脂蛋白胆固醇(high density lipoproteincholesterol,HDL-C)升高,治疗前后血脂水平比较差异有统计学意义(P<0.01或P<0.05)。他汀类药物治疗后19例飞行人员LDL-C达标,2例不达标。(2)21例飞行人员对他汀类药物耐受性良好,治疗前后血肌酐(serum creatinine,Scr)、谷丙转氨酶(glutamic pyruvic transaminase,GPT)和肌酸激酶(creatine kinase,CK)的变化差异无统计学意义。(3)47处冠状动脉病变治疗后41处出现逆转或无明显进展,4处轻度进展,2处明显进展。(4)飞行结论14例飞行合格予以放飞,7例飞行不合格。结论他汀类药物治疗能够改善血脂,显著降低LDL-C水平,逆转或稳定动脉粥样硬化斑块,减轻冠状动脉狭窄。Objective To evaluate the efficacy of statins therapy among flight crew with coronary artery atherosclerosis. Methods Twenty-one flight crew diagnosed with coronary artery atherosclerosis received statins therapy daily and accepted coronary angiography after treatment of two years to reevaluate coronary artery stenosis. Adverse reactions of statins were monitored during the treatment and the changes of lipid levels and the risk of coronary vessel disease were observed along with the changes of coronary artery stenosis. Results After twelve months of statins therapy, the serum levels of LDL-C, total cholesterol and triglyceride were significantly decreased, while HDL-C increased. The The differences were statistically significant （P〈0.01 or P〈0.05）. The serum LDL-C level of nineteen cases of flight crew reached the standard. Coronary vessel plaques showed a reversal or no obvious progression in forty-one of the forty-seven cases, and four cases of plaque showed minor progression and another two cases showed obvious progression. Fourteen of the flight crew were qualified to fly again by medical identification and seven failed. Conclusion Statins therapy can significantly improve the lipid level, lower the level of LDL-C, reverse or stabilize the atherosclerotic plaque to reduce coronary artery stenosis.

关 键 词：他汀类药物 动脉粥样硬化 冠状动脉 冠状动脉造影术 

分 类 号：R85[医药卫生—航空、航天与航海医学] R541.4[医药卫生—临床医学]