论文部分内容阅读
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。
Objective To investigate the clinical effects of different doses of atorvastatin on elderly patients with acute coronary syndrome (ACS). Methods Totally 86 ACS patients were randomly divided into atorvastatin low dose group and high dose group, with 43 cases in each group. Both groups were given routine treatment. The low-dose group received 10 mg / d of atorvastatin orally on the basis of routine treatment. The high-dose group received 20 mg / d of atorvastatin on the basis of conventional treatment. Both groups were treated 1 year. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein Cholesterol (HDL-C), incidence of cardiovascular events within one year and the incidence of adverse reactions. Results The levels of TC and LDL-C in both groups were significantly lower than those before treatment (P <0.05 or P <0.01) after 2 weeks, 3 months, 6 months and 12 months. After 3 months, 6 months (P <0.05 or P <0.01). After 12 months of treatment, the HDL-C in both groups was significantly lower than that before treatment (P <0.05). The levels of TC and LDL-C in the high-dose group were significantly lower than those in the low-dose group at 2, 3, 6 and 12 months after treatment (P <0.05). After 3 months, 6 months and 12 months Compared with the low-dose group, the TG level in the high-dose and high-dose groups was significantly lower than that in the low-dose group (P <0.05). The incidence of angina pectoris, recurrent myocardial infarction and sudden cardiac death in high dose group were significantly lower than those in low dose group (P <0.05 or P <0.01). There was no significant difference in the incidence of adverse reactions between low-dose and high-dose groups (P> 0.05). Conclusions Atorvastatin 20 mg / d has better lipid-lowering effect, fewer cardiovascular events, and patient tolerance. It is worthy of clinical application.