不同剂量瑞舒伐他汀对老年急性冠脉综合征患者血管内皮功能及血脂水平的影响

目的：观察不同剂量瑞舒伐他汀对急性冠脉综合征(ACS)老年患者内皮细胞微粒及血脂水平的影响。方法选取2013年4月至2014年11月在我院心内科治疗的ACS老年患者82例，按数表法随机分为低剂量组和高剂量组各41例，两组患者均予以常规内科治疗。此外，低剂量组口服10 mg/d瑞舒伐他汀，高剂量组口服20 mg/d瑞舒伐他汀，两组均持续治疗14 d，观察治疗前后两组患者的内皮细胞微粒指标值、血脂水平以及副作用等情况。结果治疗14 d后，低剂量组与高剂量组血液中血小板内皮细胞黏附分子/膜糖蛋白(CD31+/CD42b-EMP)水平分别为(822.63±63.41)μL、(693.57±57.26)μL，较治疗前的(1160.46±174.23)μL、(1192.51±160.45)μL均有明显的下降(P<0.05或P<0.01)，而高剂量组治疗前后CD31+/CD42b-EMP水平下降程度较低剂量组更为明显(P<0.05)；运用瑞舒伐他汀治疗14 d后，低剂量组患者低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)水平分别为(2.12±0.23) mmol/L、(1.33±0.27) mmol/L、(1.72±0.53) mmol/L、(4.61±0.51) mmol/L，高剂量组分别为(1.74±0.33) mmol/L、(1.42±0.28) mmol/L、(1.48±0.52) mmol/L、(4.28±0.36) mmol/L，两组各指标比较差异具有统计学意义(P<0.05或P<0.01)；两组用药期间均未出现严重的不良反应。结论对急性冠脉综合征老年患者运用瑞舒伐他汀治疗，能明显改善血管内皮功能与血脂水平，同时20 mg/d剂量的治疗效果优于10 mg/d常规剂量，且不会增加老年患者的药物副作用及相关并发症。

Effect of different doses of rosuvastatin on endothelial function and blood lipid level in elderly patients with acute coronary syndrome

Objective To observe the effect of different doses of rosuvastatin on endothelial function and blood lipid level in elderly patients with acute coronary syndrome (ACS). Methods A total of 82 cases of elderly pa-tients with ACS, who admitted to our hospital from April 2013 to November 2014, were randomly divided into low-dose-group (n=41) and high-dose-group (n=41) by random number table. The two groups were treated with regular medical treatment. In addition, low-dose-group and high-dose-group were respectively treated with oral 10 mg/d and 20 mg/d rosuvastatin for 14 d. The endothelial cell particles index, blood lipid level and side effects of the two groups be-fore and after the treatment were observed. Results The blood platelet endothelial cell adhesion molecule and membrane glycoprotein (CD31+/CD42b-EMP) level in low-dose group and high-dose-group 14 d after treatment [(822.63±63.41) μL, (693.57 ± 57.26) μL] were significantly lower than before treatment [(1 160.46 ± 174.23) μL, (1 192.51 ± 160.45) μL] (P<0.05 or P<0.01), while the decrease of CD31+/CD42b-EMP level in high-dose-group before and after treatment was more obvious than those in low-dose-group (P<0.05);14 d after therapy with rosuvastatin, there were significantly differences between the low-dose-group [(2.12±0.23) mmol/L, (1.33±0.27) mmol/L, (1.72±0.53) mmol/L, (4.61±0.51) mmol/L, respec-tively] and the high-dose-group [(1.74 ± 0.33) mmol/L, (1.42 ± 0.28) mmol/L, (1.48 ± 0.52) mmol/L, (4.28 ± 0.36) mmol/L] in the low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), total cho-lesterol (TC) levels (P<0.05 or P<0.01). There was no serious adverse reaction during the drug use. Conclusion For el-derly patients with ACS, rosuvastatin treatment can significantly improve endothelial function and blood lipid levels. Fur-thermore, the dose of 20 mg/d has better treatment effect than 10 mg/d routine dose, which do not increase the drug side effects and related complications in the elderly patients.