论文部分内容阅读
目的 比较中、小剂量阿托他汀钙对75岁以上心血管疾病中、高危患者的干预效果和安全性。方法 选取龙华街道社区卫生服务中心门诊患者中75周岁以上动脉粥样硬化性心血管病（ASCVD）危险分层为中高危患者262例，随机分为阿托伐他汀钙小剂量组（10 mg/d，10 mg组，n=119）和中剂量组（20 mg/d，20 mg组，n=143），结合生活方式干预12个月，两组人群分别于服药前和服药后12个月时进行血脂、空腹血糖（静脉）、肝和肾功能相关指标检测。结果 两组患者在给药前的性别、年龄、主要并发疾病（高血压病、高脂血症）的患病率、吸烟率、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、空腹葡萄糖(FPG)、丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶(γ-GT)和血尿素氮（BUN）差异均无统计学意义，虽然20 mg组血清肌酐（SCr）水平高于10 mg组（P<0.05），但两组血清肌酐（SCr）异常率没有统计学差异。总体而言两种剂量的阿托伐他汀钙片干预12个月均可显著降低TC和LDL-C水平（P<0.01），而其中20 mg组可更显著降低LDL-C，并能更好实现降脂达标率（54.7%）。干预前后以及不同剂量治疗组之间的的FPG、ALT、AST、γ-GT和BUN均无统计学差异，虽然干预后可观察到两组SCr值均高于治疗前，且20 mg组SCr值也显著高于10 mg组，但SCr的异常率在治疗前后和两个治疗组之间均无明显差异。结论 阿托伐他汀钙在75岁以上动脉粥样硬化性血管危险分层中、高危人群具有良好的降脂效果，虽可轻微的影响其肾功能而无明显其他副作用。
Objective To compare the effect and safety of middle and low dose of atorvastatin calcium on middle-and high-risk patients over 75 years of age with cardiovascular diseases. Methods A total of 262 middle- and high-risk patients with atherosclerotic cardiovascular disease (ASCVD) over 75 years of age were randomly assigned to low-dose atorvastatin calcium (10 mg / d, 10 mg group, n = 119) and middle dose group (20 mg / d, 20 mg group, n = 143), combined with lifestyle intervention for 12 months. When the blood lipids, fasting blood glucose (veins), liver and kidney function related indicators detection. Results The prevalence, smoking rate, low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) in the two groups before treatment were significantly higher than those before treatment , Fasting glucose (FPG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GT) and blood urea nitrogen (BUN) There was no statistical significance. Although serum creatinine (SCr) level in 20 mg group was higher than that in 10 mg group (P <0.05), there was no significant difference in serum creatinine (SCr) abnormalities between the two groups. Overall, TC and LDL-C levels were significantly lower at both doses of atorvastatin calcium for 12 months (P & lt; 0.01), with 20 mg being more effective in lowering LDL-C and better Achieve lipid-lowering compliance rate (54.7%). There were no significant differences in FPG, ALT, AST, γ-GT and BUN before and after intervention and between different doses of treatment group, although SCr values in both groups were significantly higher than those before treatment, and SCr values in 20 mg group Also significantly higher than the 10 mg group, but the abnormal rate of SCr in the treatment before and after treatment and no significant difference between the two groups. Conclusions In atherosclerotic vascular atherosclerotic stratification atherosclerosis over 75 years of age, atorvastatin calcium has a good lipid-lowering effect, although it may slightly affect its renal function without any significant side effects.