辛伐他汀对携带乙肝病毒的老年冠心病患者的疗效  

Simvastatin combined with telbivudine in treatment of coronary heart disease in elderly hepatitis B virus carriers

作　　者：关树英 张磊 GUAN Shu-Ying;ZHANG Lei(Department of Pharmacy,Special Medical Center of Armed Police Force,Tianjin 300162,China)

机构地区：[1]武警特色医学中心药剂科,天津300162

出　　处：《中华老年多器官疾病杂志》2022年第5期350-354,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨辛伐他汀对携带乙肝病毒(HBV)的老年冠心病患者血脂水平、肝损害程度及临床预后的影响。方法选取2018年12月~2019年12月武警特色医学中心收治的携带HBV的110例老年冠心病患者为研究对象,按随机数表法将患者分为2组。对照组行西医综合治疗,治疗组在此基础上加用辛伐他汀治疗,连续治疗6个月。比较2组患者血脂水平、肝损害程度、乙肝病毒脱氧核糖核酸(HBV DNA)载量及再激活情况,并进一步分析其对预后的影响。采用SPSS 23.0统计软件进行数据分析,根据数据类型分别采用单因素方差分析、t检验或χ^(2)检验进行组间比较。结果2组患者治疗6个月及随访时总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平明显低于治疗前,高密度脂蛋白胆固醇(HDL-C)水平明显高于治疗前;随访时治疗组TC、LDL-C水平明显低于对照组,HDL-C水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗3、6个月及随访时治疗组HBV DNA载量明显低于对照组[(2.82±0.46)×10^(6)和(6.63±1.58)×10^(6)copies/ml,(2.52±0.38)×10^(6)和(6.54±1.55)×10^(6)copies/ml,(2.11±0.20)×10^(6)和(6.88±1.78)×10^(6)copies/ml];随访时HBV DNA再激活率低于对照组(7.27%和45.45%),预后结果明显优于对照组,差异均有统计学意义(P<0.05)。2组患者治疗方案的变更情况差异有统计学意义(P<0.05);但肝肾功能损伤情况比较,差异无统计学意义(P>0.05)。结论辛伐他汀治疗携带HBV的老年冠心病患者,不仅调脂效果佳,还可抑制HBV DNA的复制及降低HBV DNA的再激活率,且不会加重肝损害,安全性良好。Objective To determine the effect of simdestatin on the blood lipid level,liver damage and clinical prognosis of elderly patients with coronary heart disease carrying hepatitis B virus(HBV).Methods A total of 110 elderly HBV carriers with coronary heart disease admitted in our hospital from December 2018 to December 2019 were recruited in this study.They were randomly divided into control group(comprehensive treatment of Western medicine)and treatment group(added with simvastatin treatment).After 6 consecutive months′treatment,the blood lipid levels,liver damage,HBV DNA load and reactivation were compared between the 2 groups,and the impact on the prognosis was further analyzed.SPSS statistics 23.0 was used for data analysis,and one-way analysis of variance,student′s t test or Chi-square test was performed for comparison between groups depending on different data types.Results The levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)were decreased and that of high-density lipoprotein cholesterol(HDL-C)was increased in the 2 groups after treatment and during follow-up.The levels of TC and LDL-C were significantly lower and the HDL-C level was significantly higher in the treatment group than the control group during follow-up(P<0.05).After 3 and 6 months of treatment and during follow-up,the treatment group obtained obviously lower HBV DNA load than the control group[(2.82±0.46)×10~6 vs(6.63±1.58)×10^(6)copies/ml,(2.52±0.38)×10^(6)vs(6.54±1.55)×10^(6)copies/ml,(2.11±0.20)×10^(6)vs(6.88±1.78)×10^(6)copies/ml,P<0.05].The HBV DNA reactivation rate were significantly lower(7.27%vs 45.45%,P<0.05)and prognosis results were better in the treatment group than the control group in follow-up period.But there was changes in treatment regimens(P<0.05),but no significant difference in liver and kidney damage between the 2 groups(P>0.05).Conclusion Simvastatin not only exerts good effectiveness in regulating lipids,but also inhibits the replication and reduces the reactivation rate of HBV DNA

关 键 词：老年人 冠心病 乙肝病毒携带者 辛伐他汀 替比夫定 肝功能 

分 类 号：R541.4[医药卫生—心血管疾病]