老年患者应用不同类型他汀类药物的疗效及安全性评价

目的观察不同剂量和类型他汀类药物在老年高脂血症患者中应用的疗效与安全性。方法回顾性分析456例老年高脂血症患者服用他汀类药物情况,根据服药情况分为:阿托伐他汀组(169例)、辛伐他汀组(110例)、普伐他汀组(137例)和氟伐他汀组(40例);又根据《中国成人血脂异常防治指南》将患者分为中危(41例)、高危(232例)和极高危(183例)。观察治疗8周后血脂水平及不良反应。结果与治疗前比较,阿托伐他汀组、辛伐他汀组、普伐他汀组和氟伐他汀组治疗8周后血清TC、LDL-C水平均明显降低(P0.05,P0.01)。4组治疗前后血清TG水平差异无统计学意义(P0.05)。阿托伐他汀组、辛伐他汀组治疗8周后血清TC、LDL-C变化率与普伐他汀组、氟伐他汀组比较差异有统计学意义(P0.05)。各组中高危患者服用标准剂量他汀类药物治疗后,LDL-C达标率均在80%以上,极高危患者达标率为44.1%～55.7%。结论多数老年高脂血症患者服用小剂量和(或)标准剂量他汀类药物血脂即可达标。且治疗安全性好,无严重不良反应发生。

The therapeutic efficacy and safety of different statins in elderly

Objective To evaluate the therapeutic efficacy and safety of different doses and types of statins in elderly patients with hyperlipemia.Methods 456 patients who were given different doses and types of statins(atovastatin 169 patients,simvastatin 110 patients,pravastatin 137 patients and fluvastatin 40 patients) were analyzed retrospectiely.The changes of serum level of TG,TC and LDL-C were examined before and after treatment for 8 weeks ,and the adverse effects of statins were observed.Results Serum levels of LDL-C and TC were lowered significantly after treatment for 8 weeks in atovastatin,simvastatin,pravastatin and fluvastatin groups (P < 0.05, P < 0.01).Serum levels of TG were not statisticaly different after treatment in all patients (P > 0.05).Serum levels of LDL-C and TC decreased more significantly after treatment with atovastatin and simvastatin than with pravastatin and fluvastatin (P< 0.05).The rate of reaching target levels of LDL-C was above 80% in moderate risk patients and high risk patients,and was 44.1% — 55.7% in very high risk patients.There was no statistical difference in the rates of reaching target level of LDL-C in all patients (P > 0.05).Forty-two patients(9.2%) suffered from elevation of alanine aminotransferase which became normal after treatment.Four patients(0.9%) showed abnormal creatine kinase within 2 times of upper limit of normal level,and there were no severe hepatic damage or rhabdomyolysis events.Conclusion The standard dosage of statins in treatment of hyperlipoidemia in most of elderly is effective and safe.