短期他汀类药物强化治疗老年急性冠脉综合征的调脂效果及其对肝肾功能的影响  

Impact of Short-term Intensive Therapy with Atorvastatin on Lipid Regulation and the Function of the Liver and the Kidney in Older Patients with Acute Coronary Syndrome

作　　者：蒋桦 夏春香 于海亮 杨立艳 李淑忱 李树荣 苏兵 Jiang Hua;Xia Chunxiang;Yu Hailiang;Yang Liyan;Li Shuchen;Li Shurong;Su Bing(Department of Internal Medicine,the Second People's Hospital of Tangshan,Tangshan 063000,China;Department of Hemodialysis,the Second People's Hospital of Tangshan,Tangshan 063000,China;Department of Clinical Electrophysiology,Hengshui People's Hospital,Hengshui 053000,China)

机构地区：[1]唐山市第二人民医院内一科,唐山063000 [2]唐山市第二人民医院血透室,唐山063000 [3]衡水市人民医院临床电生理科,衡水053000

出　　处：《国际老年医学杂志》2020年第4期213-215,240,共4页International Journal of Geriatrics

基　　金：河北省衡水市科学技术研究与发展计划(科技支撑计划)(15020)。

摘　　要：目的探讨短期阿托伐他汀强化治疗老年急性冠脉综合征(ACS)的调脂效果及对肝肾功能的影响。方法选取2016年1月~2018年2月唐山市第二人民医院收治的126例老年ACS患者,随机均分为对照组和观察组。对照组在常规药物治疗基础上给予20 mg阿托伐他汀口服,观察组在常规药物治疗基础上给予40 mg阿托伐他汀口服。服药时间均为1个月。比较治疗前后两组血脂水平、肝肾功能。结果治疗后,两组血脂指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]显著低于治疗前,高密度脂蛋白胆固醇(HDL-C)显著高于治疗前(P<0.05);与对照组相比,观察组TG、TC、LDL-C明显降低、HDL-C明显升高(P<0.05);两组肝功能指标[谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]显著高于治疗前(P<0.05),但组间比较差异无统计学意义(P>0.05);与对照组相比,观察组的肾功能指标血肌酐(Scr)明显降低、肾小球滤过率(eGFR)明显升高(P<0.05),心肌功能指标肌酸激酶(CK)明显降低(P<0.05),炎症指标C反应蛋白(CRP)明显降低(P<0.05)。结论短期强化剂量阿托伐他汀治疗老年ACS临床效果显著,可降低血脂水平,还可保护心肝肾功能,减轻炎症损伤。Objective To investigate the effect of short-term intensive therapy with atorvastatin on lipid regulation and the function of the liver and the kidney in older patients with acute coronary syndrome.Methods 126 older patients with acute coronary syndrome in the Second People's Hospital of Tangshan from January 2016 to February 2018 were randomly divided into the control group and the observation group.The control group was given 20 mg of atorvastatin orally for 1 month.The observation group was given 40 mg of atorvastatin for 1 month.The blood lipid level,the liver and the kidney function in the two groups were compared before and after treatment.Results After treatment,the level of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein(LDL-C)in the two groups were significantly lower than those before treatment,and high-density lipoprotein(HDL-C)was significantly higher than that before treatment(P<0.05).Compared with the control group,the levels of TG,TC and LDL-C were significantly reduced and the levels of HDL-C was significantly increased in the observation group(P<0.05).The level of ALT and AST in the two groups were significantly higher than those before treatment(P<0.05),but there were no significant difference in the levels of ALT and AST between the observation group and the control group(P>0.05).Compared with the contrd group the level of serum creatinine(Scr)was decreased and the level of eGFR was incrased(P<0.05),the level of CK was decreased(P<0.05),the level of CRP was decreased in the observation group(P<0.05).Conclusion Short-term intensive dose of atorvastatin might be effective and safe in the treatment of older patients with acute coronary syndrome,protect the renal function and myocardial function,and reduce the inflammatory damage.

关 键 词：阿托伐他汀 急性冠脉综合征 血脂 肝肾功能 

分 类 号：R541.4[医药卫生—心血管疾病]