不同他汀类药物对老年冠心病患者血脂水平及颈动脉斑块的影响  

Effects of different statins on blood lipid level and carotid plaque in elderly patients with coronary heart disease

作　　者：陈雅倩[1] 张传军[1] 于春强[2] 王联欢 王士凯[2] 印建荣[2] CHEN Yaqian;ZHANG Chuanjun;YU Chunqiang;WANG Lianhuan;WANG Shikai;YIN Jianrong(Department of Pharmacy,Pizhou People's Hospital,Jiangsu,Pizhou 221300,China;Department of Cardiology,Pizhou People's Hospital,Jiangsu,Pizhou 221300,China)

机构地区：[1]江苏省邳州市人民医院药剂科,江苏邳州221300 [2]江苏省邳州市人民医院心内科,江苏邳州221300

出　　处：《中国医药科学》2019年第21期53-55,77,共4页China Medicine And Pharmacy

摘　　要：目的探讨不同他汀类药物对老年冠心病患者血脂水平及颈动脉斑块的影响。方法选取2017年2月~2018年12月我院收治的老年冠心病合并血脂异常患者80例,随机分为瑞舒伐他汀组及阿托伐他汀组,每组40例。分别于治疗前、治疗3个月采用全自动生化分析仪检测LDL-C、TC、HDL-C及TG,采用飞利浦彩色多普勒超声诊断仪监测CIMT。结果与治疗前比较,治疗3个月两组患者的TC、TG、LDL-C水平明显降低,HDL-C水平明显升高,差异有统计学意义(P<0.05)。治疗3个月,瑞舒伐他汀组HDL-C明显高于阿托伐他汀组,TC、TG、LDL-C水平低于阿托伐他汀组,差异有统计学意义(P<0.05)。治疗前两组CIMT比较差异无统计学意义(P>0.05)。治疗3个月后,两组CIMT明显低于治疗前,且瑞舒伐他汀组CIMT明显低于阿托伐他汀组,差异有统计学意义(P<0.05)。两组患者均未出现横纹肌溶解等不良反应。结论老年冠心病患者对他汀类药物安全性和耐受性良好,瑞舒伐他汀调脂效果优于阿托伐他汀治疗,推荐根据指南使用中等剂量他汀。Objective To investigate the effect of different statins on blood lipid level and carotid plaque in elderly patients with coronary heart disease. Methods 80 elderly patients with coronary heart disease and dyslipidemia admitted to Pizhou People’s Hospital between February 2017 and December 2018 were randomly divided into rosuvastatin group and atorvastatin group, with 40 in each group. Low-density lipoprotein cholesterol(LDL-C), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C) and triglyceride(TG) were detected by automatic biochemical analyzer before and 3 months after treatment, and CIMT was monitored by Philips color Doppler ultrasound. Results After 3 months of treatment, TC, TG, LDL-C levels of the two groups were significantly lower, HDL-C levels were significantly higher as compared with those before treatment(P<0.05). After 3 months of treatment, HDL-C level of rosuvastatin group was significantly higher than that of atorvastatin group, and the levels of TC, TG and LDL-C were lower than those of atorvastatin group, and the differences were statistically significant(P<0.05). There was no significant difference in carotid intima-media thickness(CIMT) between the two groups before treatment(P>0.05). After 3 months of treatment, CIMT in the two groups was significantly lower than that before treatment, and CIMT in the rosuvastatin group was significantly lower than that in the atorvastatin group(P<0.05). There were no adverse reactions such as rhabdomyolysis in both groups. Conclusion The elderly patients with coronary heart disease have good tolerance to statins. Rosuvastatin is better than atorvastatin in lipid regulation. It is recommended to use moderate dose statins according to the guidelines.

关 键 词：瑞舒伐他汀钙片 阿托伐他汀 冠心病 颈动脉粥样硬化 血脂异常 

分 类 号：R541.4[医药卫生—心血管疾病]