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目的研究脑梗死患者长期二级预防中应用辛伐他汀与阿托伐他汀的效果、不良反应和依从性。方法汇总8个协作点的初发性脑梗死患者2 586例,分为辛伐他汀组1 404例、阿托伐他汀组1 182例,2组均应用5～20 mg每天晚饭后口服;脑梗死的高危患者LDL-C水平<2.6 mmol/L为达标,脑梗死的极高危患者LDL-C水平<2.1 mmol/L为达标,予以长期维持,2年后进行对照评定。结果2组患者治疗后早期达标率、不良反应发生率和终点事件发生率相比较,差异无统计学意义(P>0.05)。2组每年人均药费花费、患者失访率及退出改组率对比,差异有统计学意义(P<0.01)。结论辛伐他汀与阿托伐他汀相比,均具有疗效显著可靠安全,但价格低廉,适合国情现状,脑梗死患者二级预防应用辛伐他汀治疗是国人的较佳选择,长期服药的治疗率较高,依从性较好。
Objective To study the effects, adverse reactions and compliance of simvastatin and atorvastatin in long-term secondary prevention of patients with cerebral infarction. Methods A total of 2 586 patients with initial cerebral infarction were selected and divided into four groups: 1 404 cases in simvastatin group and 1 182 cases in atorvastatin group. Both groups were given oral administration of 5 ~ 20 mg daily after dinner. Brain High-risk patients with infarction LDL-C level of <2.6 mmol / L as the standard, high-risk patients with cerebral infarction LDL-C levels <2.1 mmol / L as standard, to be long-term maintenance, 2 years after the control assessment. Results There was no significant difference between the two groups in the early compliance rate, the incidence of adverse reactions and the incidence of end points after treatment (P> 0.05). The annual per capita medical expenses, the rate of loss of follow-up and the rate of withdrawal and reorganization in the two groups were statistically significant (P <0.01). Conclusion Compared with atorvastatin, simvastatin has significant efficacy and safety, but its price is low, which is suitable for the actual conditions in China. Simvastatin is the best choice for secondary prevention in Chinese patients with cerebral infarction. The long-term treatment rate Higher compliance is better.