不同剂量阿托伐他汀治疗老年急性冠脉综合征疗效评价

目的探讨不同剂量阿托伐他汀治疗老年急性冠脉综合征(ACS)的临床疗效。方法 86例ACS患者随机分为阿托伐他汀低剂量组和高剂量组,每组43例。两组患者均给予常规治疗,低剂量组在常规治疗基础上口服10 mg/d阿托伐他汀,高剂量组患者在常规治疗的基础上口服20 mg/d阿托伐他汀,两组均治疗1年。于治疗前、治疗后2周、3个月、6个月、12个月观察患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),1年内心血管事件发生情况以及不良反应发生情况。结果治疗后2周、3个月、6个月和12个月,两组患者TC及LDL-C均较治疗前显著降低(P<0.05或P<0.01);治疗后3个月、6个月和12个月,两组患者TG较治疗前显著降低(P<0.05或P<0.01);治疗后12个月,两组患者HDL-C较治疗前显著降低(P<0.05)。治疗后2周、3个月、6个月和12个月,高剂量组TC及LDL-C均显著低于低剂量组(P<0.05);治疗后3个月、6个月和12个月,高剂量组TG显著低于低剂量组(P<0.05);而治疗后12个月,高剂量组HDL-C显著低于低剂量组(P<0.05)。高剂量组患者心绞痛、再发心肌梗死及心源性猝死的发生率均显著低于低剂量组(P<0.05或P<0.01)。低剂量组与高剂量组不良反应发生率差异无统计学意义(P>0.05)。结论 20 mg/d阿托伐他汀具有更好的降脂作用,心血管事件发生较少,患者耐受性好,值得临床推广使用。

Evaluation on Therapeutic Effect of Different Doses of Atorvastatin on Elderly Acute Coronary Syndrome

Objective To explore the clinical efficacy of different doses of atorvastatin in treatment of elderly acute coronary syndrome（ACS）.Methods Eighty-six patients with ACS were randomly divided into low-dose atorvastatin group and high-dose atorvastatin group（each n=43）.All patients received routine treatment,in addition,low-dose group was orally administered with 10 mg/d atorvastatin and high-dose group administered with 20 mg/d atorvastatin for 1 year.The total cholesterol（TC）,triacylglycerol（TG）,low-density lipoprotein-cholesterol（LDL-C） and high density lipoprotein-cholesterol（HDL-C） before treatment,2 weeks,3 months,6 months and 12 months after treatment were determined,and the cardiovascular events within 1 year and adverse drug reactions（ADRs） were observed.Results Two weeks,3 months,6 months and 12 months after treatment,TC and LDL-C of the two groups were significantly decreased than those before treatment（P〈0.05 or P〈0.01）.3 months,6 months and 12 months after treatment,TG of the two groups was significantly decreased than that before treatment（P〈0.05 or P〈0.01）.12 months after treatment,HDL-C of the two groups was significantly decreased than that before treatment（P〈0.05）.2 weeks,3 months,6 months and 12 months after treatment,TC and LDL-C of high-dose group were statistically decreased than those of low-dose group（P〈0.05）.3 months,6 months and 12 months after treatment,TG of high-dose group was statistically decreased than that of low-dose group（P〈0.05）.12 months after treatment,HDL-C of high-dose group was statistically decreased than that of low-dose group（P〈0.05）.The incidence rates of angina,recurrent myocardial infarction and sudden cardiac death of high-dose group were significantly lower than those of low-dose group（P〈0.05 or P〈0.01）.No statistically significant difference was found in the incidence rate of ADRs between the two groups（P〈0.05）.Conclusions The dosage of atorvastatin 20 mg/d has a better effect in reducing blood lipids,with lower incidence of cardiovascular events and better treatment tolerance for patients.It is worthy of being extensively applied in clinical practice.