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目的观察不同剂量瑞舒伐他汀对急性冠脉综合征(ACS)老年患者内皮细胞微粒及血脂水平的影响。方法选取2013年4月至2014年11月在我院心内科治疗的ACS老年患者82例,按数表法随机分为低剂量组和高剂量组各41例,两组患者均予以常规内科治疗。此外,低剂量组口服10 mg/d瑞舒伐他汀,高剂量组口服20 mg/d瑞舒伐他汀,两组均持续治疗14 d,观察治疗前后两组患者的内皮细胞微粒指标值、血脂水平以及副作用等情况。结果治疗14 d后,低剂量组与高剂量组血液中血小板内皮细胞黏附分子/膜糖蛋白(CD31+/CD42b-EMP)水平分别为(822.63±63.41)μL、(693.57±57.26)μL,较治疗前的(1 160.46±174.23)μL、(1 192.51±160.45)μL均有明显的下降(P<0.05或P<0.01),而高剂量组治疗前后CD31+/CD42b-EMP水平下降程度较低剂量组更为明显(P<0.05);运用瑞舒伐他汀治疗14 d后,低剂量组患者低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)水平分别为(2.12±0.23)mmol/L、(1.33±0.27)mmol/L、(1.72±0.53)mmol/L、(4.61±0.51)mmol/L,高剂量组分别为(1.74±0.33)mmol/L、(1.42±0.28)mmol/L、(1.48±0.52)mmol/L、(4.28±0.36)mmol/L,两组各指标比较差异具有统计学意义(P<0.05或P<0.01);两组用药期间均未出现严重的不良反应。结论对急性冠脉综合征老年患者运用瑞舒伐他汀治疗,能明显改善血管内皮功能与血脂水平,同时20 mg/d剂量的治疗效果优于10 mg/d常规剂量,且不会增加老年患者的药物副作用及相关并发症。
Objective To observe the effect of rosuvastatin with different dosages on endothelial cell particles and blood lipid in elderly patients with acute coronary syndrome (ACS). Methods From April 2013 to November 2014, 82 elderly patients with ACS undergoing cardiology in our hospital were randomly divided into low dose group and high dose group, 41 cases in each group according to the method of count table. Both groups were given conventional medical treatment . In addition, low-dose group oral administration of 10 mg / d rosuvastatin, high-dose group of oral administration of 20 mg / d rosuvastatin, two groups were treated for 14 days, observed before and after treatment in both groups of endothelial cell particle index, Level and side effects and so on. Results After 14 days of treatment, the levels of CD31 + / CD42b-EMP in the blood of low-dose and high-dose groups were (822.63 ± 63.41) μL and (693.57 ± 57.26) μL, respectively, (1 160.46 ± 174.23) μL, (1 192.51 ± 160.45) μL before treatment were significantly decreased (P <0.05 or P <0.01), while the levels of CD31 + / CD42b-EMP decreased significantly (P <0.05). After treatment with rosuvastatin for 14 days, low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (2.12 ± 0.23) mmol / L, (1.33 ± 0.27) mmol / L, (1.72 ± 0.53) mmol / L and (4.61 ± 0.51) mmol / L respectively in high dose group and high dose group (1.74 ± 0.33) mmol / L, (1.42 ± 0.28) mmol / L, (1.48 ± 0.52) mmol / L and (4.28 ± 0.36) mmol / L respectively.The differences between the two groups were statistically significant (P < 0.05 or P <0.01). No serious side effects occurred during the two groups. Conclusion The use of rosuvastatin in elderly patients with acute coronary syndrome can significantly improve vascular endothelial function and blood lipid levels, while the 20 mg / d dose is superior to the 10 mg / d conventional dose and does not increase elderly patients Side effects of medications and related complications.