不同剂量阿托伐他汀治疗冠心病伴高脂血症的临床疗效观察

目的:观察不同剂量阿托他伐汀早期强化治疗冠心病伴高脂血症患者的临床疗效。方法:随机将60例冠心病伴高脂血症患者分为两组,A组为阿托伐他汀常规降脂组,30例,20 mg/d;B组为强化降脂组,30例,40 mg/d。两组常规治疗药物有抗血小板聚集制剂、抗凝剂、β受体阻滞剂、钙通道阻滞剂、硝酸盐类、ACEI类等,均未接受介入治疗。在常规治疗基础上,A组给予阿托伐他汀20 mg/d;B组给予阿托伐他汀40 mg/d,睡前服用1次。治疗期间所有入选患者的饮食习惯及生活方式不变,不用影响血脂代谢的其他药物。分别于用药前及用药6个月后测定总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG);记录6个月内发生的心血管事件及不良反应、血脂达标率以及肝肾功能的变化。结果:①常规降脂组与强化降脂组治疗后与治疗前比较,两组患者的TC、TG、LDL-C、均显著下降(P<0.05)。②常规降脂组与强化降脂组治疗后比较,TC、LDL-C下降程度比较差异有统计学意义(P<0.05)。③6个月内主要心血管事件,强化降脂组与常规降脂组比较,心血管事件比例明显降低(P<0.05)。结论:①强化降脂治疗能更有效的发挥其调脂作用,减少心血管危险事件的发生。②应用阿托伐他汀20 mg及40 mg无明显不良反应,安全性是相一致的。

Clinical effects of different doses of atorvastatin treatment of hyperlipidemia in coronary heart disease

Objective To observe the effects of different doses of atorvastatin in early intensive treatment of coronary heart disease with hyperlipidemia.Method Total 60 patients with coronary heart disease with hyperlipidemia were divided into two groups randomly,group A of conventional lipid-lowering atorvastatin group（n=30）,20 mg daily;group B of intensive lipid-lowering group（n=30）,40 mg daily.The conventional therapies in the two groups were anti-platelet aggregation agents,anticoagulants,β-blockers,calcium channel blockers,nitrates,ACEI and so on,they didn′t receive intervention.During treatment,the eating habits and life style of all selected patients didn′t change,and didn′t use other drugs influencing the lipid metabolism.Total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C） and triglycerides（TG） were detected before treatment and 6 months after treatment,respectively.Cardiovascular events,adverse reactions,standard rate and liver and kidney function in 6 months were recorded.Results ①Compared with before treatment,TC,TG and LDL-C in the two groups were significantly decreased after treatment（P0.05）.②The results of TC,LDL-C decrease level after treatment between the two groups showed significantly difference（P0.05）.③Compared with the conventional lipid-lowering group,the proportion of major cardiovascular events in 6 months decreased significantly in the intensive lipid-lowering group（P0.05）.Conclusion ①Intensive lipid-lowering therapy can be more effectively play its role in lipid-lowing and reduce risk of cardiovascular events,reverse or delay the process of coronary heart disease.②Application of Atorvastatin with 20 mg or 40 mg has no adverse reactions,and the security is the same.