辛伐他汀治疗老年冠心病的疗效及安全性研究

目的 观察老年冠心病（CHD）患者中,辛伐他汀不同剂量调脂的有效性和安全性.方法 选择确诊为CHD的老年患者124例,随机分为观察组63例和对照组61例,观察组患者给予辛伐他汀40mg,对照组给予辛伐他汀20mg,均为每晚服药1次.分别于用药前、用药后第6、12、24周空腹采静脉血清,以酶法测定总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、肌酶以及肝、肾功能等.结果 用药第6周两组患者的TC和LDL-C均比用药前明显下降,且一直保持到用药24周末（P＜0.05）.第6、12、24周的TC、LDL-C水平在观察组比对照组明显降低（P＜0.05）.观察组患者24周TC达标率（82.8%比64.9%,P＜0.05）和LDL-C达标率（83.0%比64.9%,P＜0.05）明显高于对照组.两组患者谷丙转氨酶（ALT）升高、肌酶升高等副作用的发生率未见明显差异.结论 40mg辛伐他汀能够安全而且更有效地降低 TC和LDL-C水平,使更多的CHD患者的血清胆固醇达到理想标准水平,老年患者亦可耐受此剂量.

The Efficacy and Safety of Simvastatin in Treatment of Patients with Coronary Artery Disease

Objective To evaluate the efficacy and safety of different doses of simvastatin in treatment of gerontal patients with coronary heart disease (CHD).Methods 124 gerontal patients with definite diagnosis of CHD were enrolled and randomly divided by random digits table into two groups treated with 40mg (n=63) and 20mg (n=61) simvastatin,once each night,respectively.The fasting serum levels of total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),triglyceride (TG),sero-enzyme,as well as functions of liver and kidney were determined before medication,6th,12th and 24th week after initial medication,respectively.Results The levels of TC and LDL-C were decreased significantly at 6th,12th and 24th week after initial medication (P<0.05) and at the same time,TC and LDL-C levels in observation group were continuously lower than those in control group (P<0.05).The rate of reaching target level of TC (82.8 % versus 64.9 %,P<0.05) and LDL-C (83.0 % versus 64.9 %,P<0.05) was obviously higher in observation group than in control group.There were no statistical differences in adverse effects including abnormal alanine aminotransferase and sero-enzyme between the two groups.Conclusion The simvastatin 40mg is safe and more effective in lowering total cholesterol and low density lipoprotein-cholesterol,causing more CHD cases to reach the target level of serum cholesterol.Gerontal patients can tolerate this dose either.