阿托伐他汀对老年血脂异常的调脂及非调脂作用

目的 :探讨阿托伐他汀对老年血脂异常的调脂疗效及对急性心脑血管事件的预防作用。方法 :将14 3例 6 0岁以上老年血脂异常患者随机单盲分为两组 :阿托伐他汀治疗组 73例 ,给予阿托伐他汀 10 m g/d;安慰剂对照组 70例 ,给予安慰剂 1粒 /d,疗程均为 1年。观察两组血脂变化及心脑血管事件和不良反应发生情况。结果 :阿托伐他汀治疗后总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (L DL C)、载脂蛋白 (Apo)B均明显下降 (P均 <0 .0 1) ,高密度脂蛋白胆固醇 (HDL C)、Apo A1均明显升高 (P均 <0 .0 1) ,与安慰剂对照组比较差异均有显著性 (P均 <0 .0 1) ;阿托伐他汀治疗组 TC、L DL C、TG的达标率分别为 80 %、78%和6 0 %。随访 1年 ,阿托伐他汀治疗组不稳定型心绞痛、非致命性心肌梗死、心力衰竭的发生率均较对照组明显下降 (P均 <0 .0 5 ) ;脑卒中、心律失常、心脏病所致病死率均有下降 ,两组不良反应轻微。结论 :阿托伐他汀治疗老年血脂异常有效 ,不良反应轻微。阿托伐他汀具有明显的非调脂作用 ,能有效地预防急性心脑血管事件的发生。

Effects of atorvastatin on lipid modulation and nonlipid modulation in senile patients with blood lipid abnormality

Objective: To explore the effects of atorvastatin on modulating blood lipid and preventing urgent cardiocerebral vascular event.Methods:One hundred and fortythree senile patients more than 60 years with blood lipid abnormality were randomly divided into two groups. Seventythree patients in atorvastatin group were treated with atorvastatin 10 mg/d, and 70 patients in placebo group were treated with placebo 1 tablet as control. The therapeutic course was 1 year. The changes in blood lipids and the occurrence of acute cardiocerebral vascular event and side effects were observed. Results: Total cholesterol(TC), triglycerin (TG), low density lipoproteincholesterin(LDLC), and apolipoproteins (Apo) B were all significantly decreased (all P <0 01), while the high denstity lipoproteincholesterol(HDLC) and ApoA1 were all significantly increased (both P <0 01) after atrovastatin treatment, the differences being significant compared to the placebo control group(all P <0 01). Ratio of eligibility of total TC, LDLC, and TG were 80% , 78%, 60%, respectively in atorvastatin treatment group. Followup for 1 year showed that the incidence rate of unstable angina, nonlethal myocardial infarction, heart failure in the atorvastatin group were all significantly decreased (all P <0 05 ); and the mortalities due to stroke, arrhythmia, cardiopathy were all reduced in the two groups, and the side effects were slight. Conclusion: Atorvastatin is effective for treating blood lipid abnormality in senile patients , and the side effect is mild. Atorvastatin can effectively prevent urgent cardiocerebral vascular event because of its blood lipid modulating effect.