老年冠心病患者强化降脂的疗效及安全性观察  

The effect and safety of intensive lipid-lowering therapy on elderly patients with coronary heart diseases

作　　者：邹筱冬[1] 梅克治[1] 孙爱华[1] 

机构地区：[1]广州市红十字会医院心内科,510220

出　　处：《疑难病杂志》2004年第2期83-85,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的　观察老年冠心病患者持续应用他汀类药物普伐他汀钠 (普拉固 )治疗高脂血症的疗效及安全性。方法　选择 6 5岁以上冠心病、同时符合高脂血症诊断的患者 80例 ,均经过普伐他汀钠每天 10mg治疗后血脂已达标。随机分为 2组 ,其中治疗组 4 0例 ,继续服用普伐他汀钠每天 10mg治疗 ,男性 2 2例 ,女性 18例 ,年龄 ( 70 .3± 4 .6 )岁 ;对照组 4 0例 ,停用普伐他汀钠治疗 ,男性 2 3例 ,女性 17例 ,年龄 ( 70 .7± 4 .1)岁 ;所有患者治疗前及期间均饮食治疗 ,其他按常规治疗 ;观察 3个月、12个月后 ,抽血复查血脂水平、肝肾功能 ;每月复诊时记录心力衰竭、心绞痛发作等情况 ,以观察调脂效果、肝肾功能、肌溶解等不良反应。结果　治疗组治疗 3个月后 ,TC、TG、LDL C均有明显下降 (P <0 .0 0 1) ,其中TC下降7.18% ,TG下降 12 .74 % ,LDL C下降 12 .0 0 % ;治疗 12个月后 ,治疗组TC、LDL C仍有明显下降 (P <0 .0 0 1) ,TG稍下降 ( P >0 .0 5 ) ;而BUN、GPT、Cr均无明显变化 ( P >0 .0 5 )。对照组观察 3个月、12个月后TC、TG、LDL C均有明显升高 (P <0 .0 0 1)。对照组中心力衰竭加重、心绞痛发作例数均较治疗组增多 ,治疗 12个月时尤其明显 ( P <0 .0 5 )。所有患者未出现并发症。结论　应用普伐他汀钠 (普拉?Objective To investigate the effect and safety of intensive lipid lowering therapy in elderly patients with coronary heart diseases(CHD).Methods 80 patients with CHD and hyperlipidemia were divided into treatment group (n=40) and control group (n=40), who were over 65 years old and had been treated with pravastatin 10mg,once a day ,whose cholesterol levels had reached the target. The patients in treatment group continued to receive pravastatin 10mg,once a day on the basis of diet therapy.The patients in control group stopped the administration of pravastatin and were treated only by diet therapy and routine therapy. The levels of serum lipid and serum levels of BUN,Cr,GPT,CK in all the patients were detected 3 months and 1 year after treatment; and the incidents of heart failure or angina pectoris were recorded every month.Results In the treatment group, serum levels of TC,TG, LDL C were significantly decreased 3 months after treatment. TG was reduced by 12.74%,TC was reduced by 7.18% and LDL C 12.00%. TC and LDL C still decreased greatly 1 year after treatment. However, in control group, serum TC,TG,LDL C increased both on 3 months and 1 year after treatment. The incidents of heart failure or angina pectoris in control group were more than those of treatment group. All the patients did not have complications such as skin rash, nausea, vomiting, muscle pain and dissolution, etc.Conclusion Pravastatin is effective in treating CHD in elderly patients with hyperlipidemia, which can decrease serum cholesterol levels, prevent and reduce the occurrence of cardiovascular events by intensive treatment, without side effect on liver or kidney.

关 键 词：老年人 冠心病 高脂血症 安全性 普伐他汀钠 心血管疾病 

分 类 号：R541.4[医药卫生—心血管疾病] R589.2[医药卫生—内科学]