不同剂量瑞舒伐他汀对冠状动脉搭桥术后血脂水平及1年转归情况的影响  

The effect of different doses of rosuvastatin on blood lipid levels and 1-year outcomes after coronary arterybypass surgery

作　　者：倪良春[1] 郭晓珂 宗良[1] 段晨曦 程前进[1] Ni Liangchun;Guo Xiaoke;Zong Liang;Duan Chenxi;Cheng Qianjin(Cardiac Surgery,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院心脏外科,济宁272029

出　　处：《中国医师杂志》2024年第7期1031-1034,1041,共5页Journal of Chinese Physician

基　　金：山东省中医药科技发展计划项目(2019-0474)。

摘　　要：目的探讨不同剂量瑞舒伐他汀对冠状动脉旁路移植术术后患者血脂水平及1年转归情况的影响。方法前瞻性选取2020年2月至2022年2月济宁医学院附属医院收治的冠状动脉旁路移植术术后患者106例,按照随机数字表法分为两组,大剂量组(53例)采用20 mg/d的瑞舒伐他汀治疗,小剂量组(53例)采用10 mg/d的瑞舒伐他汀治疗,对比两组治疗后临床疗效、血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、心功能指标[左心室舒张末期内径(LVDD)、左心房内径(LAD)、左室射血分数(LVEF)]、1年后随访情况[复发、再入院、死亡、心血管不良事件(MACE)]、不良反应(肝损伤、肌酸激酶升高、胃肠道反应、皮疹)。结果大剂量组总有效率为94.34%(50/53),高于小剂量组77.36%(41/53)(P<0.05);治疗后两组TC、TG、LDL-C水平均降低、HDL-C水平均升高(均P<0.05),且大剂量组TC、TG、LDL-C水平均低于小剂量组、HDL-C水平高于小剂量组(均P<0.05);治疗后两组LVDD、LAD均降低,LVEF均升高(均P<0.05),且大剂量组LVDD、LAD低于小剂量组,LVEF高于小剂量组(均P<0.05);1年后随访,大剂量组复发率为7.55%(4/53)、再入院率为5.66%(3/53),均低于小剂量组[26.42%(14/53)、20.75%(11/53)](均P<0.05),两组病死率、MACE、不良反应发生率对比差异无统计学意义(均P>0.05)。结论冠状动脉旁路移植术患者术后应用大剂量的瑞舒伐他汀能够有效降低血脂水平,改善心功能,且用药安全性较高,值得临床应用。Objective To investigate the effects of different doses of rosuvastatin on blood lipid levels and 1-year outcomes in patients undergoing coronary artery bypass grafting.Methods A total of 106 patients who underwent coronary artery bypass grafting at the Affiliated Hospital of Jining Medical University from February 2020 to February 2022 were prospectively selected and randomly divided into two groups using a random number table.The high-dose group(53 cases)was treated with 20 mg/d rosuvastatin,while the low-dose group(53 cases)was treated with 10 mg/d rosuvastatin.The two groups were compared after treatment in terms of the clinical efficacy,blood lipid levels[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],cardiac function indicators left ventricular end diastolic diameter(LVDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),one-year follow-up[recurrence,readmission,death,major adverse cardiovascular events(MACE)],and adverse reactions(liver injury,elevated creatine kinase,gastrointestinal reactions,rash).Results The total effective rate of the high-dose group was 94.34%(50/53)higher than that of the low-dose group,which was 77.36%(41/53)(P<0.05);After treatment,the levels of TC,TG,and LDL-C in both groups decreased,while the level of HDL-C increased(all P<0.05),and the levels of TC,TG,and LDL-C in the high-dose group were lower than those in the low-dose group,while the level of HDL-C was higher than that in the low-dose group(all P<0.05);After treatment,LVDD and LAD in both groups decreased,while LVEF increased(all P<0.05),and LVDD and LAD in the high-dose group were lower than those in the low-dose group,while LVEF was higher than that in the low-dose group(all P<0.05);After a one-year follow-up,the recurrence rate of the high-dose group was 7.55%(4/53),and the readmission rate was 5.66%(3/53),both lower than those of the lowdose group[26.42%(14/53),20.75%(11/53)](all P<0.05).There was no statistically signific

关 键 词：瑞舒伐他汀 冠状动脉旁路移植术 血脂 

分 类 号：R654.2[医药卫生—外科学]