他汀类药物对老年人心血管事件一级预防的疗效及安全分析  

Efficacy and safety of statins in primary prevention of cardiovascular events in elderly patients

作　　者：何旭瑜[1] 杜明轩 黎励文[1] He Xuyu;Du Mingxuan;Li Liwen(Department of Cardiology,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangdong Cardiovascular Institute,Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention,Guangzhou 510080,Guangdong Province,China)

机构地区：[1]广东省心血管病研究所广东省冠心病防治研究重点实验室广东省人民医院心内科广东省医学科学院,广州510080

出　　处：《中华老年心脑血管病杂志》2018年第7期681-685,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的评估他汀类药物对老年人心血管事件一级预防的疗效及其安全性。方法回顾性选择广东省人民医院心内科住院治疗的血脂异常患者859例,根据是否服用他汀类药物分为他汀组423例,对照组436例,比较2组疗效(主要心血管不良事件、全因死亡、脑卒中)和安全性(肝损害、肌肉损害、新发糖尿病和痴呆)。结果服用2年药物后,他汀组TC和LDL-C水平较对照组明显降低,差异有统计学意义[(4.83±0.62)mmol/L vs(5.79±0.64)mmol/L,P=0.016;(2.68±0.53)mmol/L vs(3.46±0.62)mmol/L,P=0.009]。他汀组主要心血管不良事件发生率较对照组明显降低,差异有统计学意义(13.2%vs 17.9%,P=0.032)。2组全因病死率、脑卒中、肝酶[丙氨酸转氨酶和(或)天冬氨酸转氨酶]升高、肌肉疼痛或肌酸激酶升高、新发糖尿病及痴呆发生率比较,差异无统计学意义(P>0.05)。结论老年人降低LDL-C可能有助于减少主要心血管不良事件,但由于老年人自身特点,心血管病患病率高,合并症多,病情复杂,使用他汀类药物前建议个体化衡量患者的风险获益。Objective To assess the efficacy and safety of statins in primary prevention of cardiovascular events in elderly patients.Methods Eight hundred and eighty-nine dyslipidemia patients admitted to Guangdong General Hospital from January 2012 to June 2015 were divided into statin treatment group（n=423）and control group（n=436）.The efficacy and safety of statins in prevention of major adverse cardiovascular events（MACE）,all-cause mortality,stroke,liver and muscle damage,new onset of diabetes mellitus and dementia were compared between the two groups.Results The serum levels of TC and LDL-C and the incidence of MACE were significantly lower in statin treatment group than in control group after 2 years of treatment with statins（4.83±0.62 mmol/L vs 5.79±0.64 mmol/L,P=0.016;2.68±0.53 mmol/L vs 3.46±0.62 mmol/L,P=0.009;13.2%vs 17.9%,P=0.032）.No significant difference was found in all-cause mortality,stroke,liver enzymes,muscle ache or creatinine kinase,new onset of diabetes mellitus or dementia between the two groups（P〉0.05）.Conclusion The incidence of cardiovascular disease and complications is high in elderly patients.The risk and benefit of statins should thus be carefully assessed before they are used in elderly patients.

关 键 词：血脂异常 降血脂药 肌酸激酶 心血管疾病 一级预防 

分 类 号：R54[医药卫生—心血管疾病]