他汀类药物治疗老年冠心病的安全性研究  

Safety of statins in treatment of senile coronary heart disease

作　　者：沈建中[1] 田然[1] 甄俊峰 Shen Jianzhong;Tian Ran;Zhen Junfeng(Department of Cardiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院心内科,北京100730 [2]中国医学科学院北京协和医院国际医疗部,北京100730

出　　处：《中国循证心血管医学杂志》2018年第6期723-725,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探究他汀类药物治疗老年冠状动脉粥样硬化性心脏病(冠心病)的临床疗效及安全性。方法选取2015年1月~2016年1月于北京协和医院治疗的冠心病患者153例,随机分为Ⅰ组、Ⅱ组、Ⅲ组,每组各51例。在常规治疗基础上,Ⅰ组采用阿托伐他汀、Ⅱ组采用普伐他汀、Ⅲ组采用瑞舒伐他汀,均治疗6个月并观察各组血脂变化、血脂达标率、肌酐(SCr)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)等指标,观察治疗1年后各组心血管事件和死亡发生的情况。结果治疗后,三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(非HDL-C)指标较治疗前相比显著降低(P<0.05);组间比较,Ⅲ组TC、LDL-C指标显著低于Ⅰ组、Ⅱ组(P<0.05);3组LDL-C、非HDL-C达标率均显著高于治疗前(P<0.05);治疗前后及各组间比较,ALT、CK、SCr指标,均无统计学差异性(P>0.05);治疗后1年3组出现心血管事件及死亡率,无统计学差异(P>0.05)。结论冠心病患者应用阿托伐他汀、普伐他汀、瑞舒伐他汀治疗,可有效调节血脂水平,临床疗效稳定,且总体观察安全性较好。Objective To discuss the clinical efficacy and safety of statins in treatment of senile coronary heart disease(CHD).Methods CHD patients(n=153)were chosen from Peking Union Medical College Hospital from Jan.2015 to Jan.2016,and divided randomly into group I,groupⅡand groupⅢ(each n=51).On the base of routine treatment,group I was given atorvastatin,groupⅡ,pravastatin and groupⅢ,rosuvastatin.After treatment for 6 months,the changes of blood fat,control rate of blood fat,and indexes of serum creatinine(SCr),alamine aminotransferase(ALT)and creatine kinase(CK)were observed in all groups.The incidence of cardiovascular events and mortality were observed in all groups after treatment for 1 y.Results The levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C)and non-high-density lipoprotein-cholesterol(non-HDL-C)decreased significantly in all groups after treatment(P<0.05).The levels of TC and LDL-C were significantly lower in groupⅢthan those in group I and groupⅡ(P<0.05).The control rates of LDL-C and non-HDL-C were significantly higher in 3 groups after treatment than before(P<0.05).The comparisons before and after treatment and among groups showed that ALT,CK and SCr had no statistical difference(P>0.05).The incidence of cardiovascular events and mortality had no statistical difference among 3 groups after treatment for 1 y(P>0.05).Conclusion The combined treatment of atorvastatin,pravastatin and rosuvastatin can effectively regulate level of blood fat with stable clinical efficacy and higher safety in overall observation in CHD patients.

关 键 词：他汀类药物 血脂水平 冠心病 不良反应 

分 类 号：R541.4[医药卫生—心血管疾病]