小剂量辛伐他丁对老年高脂血症患者的疗效观察

Observation on therapeutic effectiveness of low dose of simvastatin in the elderly patients with hyperlipidemia

目的 观察小剂量辛伐他丁对老年原发性高脂血症的治疗效果。方法 选择 92例老年原发性高脂血症患者 ,随机分为治疗组和对照组。治疗组 6 2例 ,每晚给予辛伐他丁 5mg ;对照组 30例 ,每日服茶碱贝特 5 0 0mg。两组均分别于服药前及服药后 4周、8周和 12周抽血检测总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL)、高密度脂蛋白(HDL)、载脂蛋白AI(apoAI)和载脂蛋白B(apoB)等。结果 小剂量辛伐他丁不仅可以显著降低TC、LDL和apoB水平 ,而且可以明显降低TG水平 ,治疗后 4～ 12周其降低幅度分别为 2 5 %～ 30 %、2 7%～ 40 %、2 5 %～ 34%和 2 0 %～36 % ,对TC、LDL、apoB的降低效果与茶碱贝特相比 ,差异有显著性意义 ;其降低胆固醇的有效率为 92 % ,远远高于茶碱贝特组的 80 % ;对TG的降低效果与茶碱贝特组相比 ,差异无显著性意义 ;同时小剂量辛伐他丁还有轻度升高HDL的作用 ,升高幅度为 0 .48%～ 8.77% ,但与茶碱贝特组比较 ,差异无显著性意义 ;对apoAI的升高作用不明显。观察期间辛伐他丁组均未出现明显副反应 ;而对照组有 3例谷丙转氨酶轻度升高。结论 小剂量辛伐他丁治疗老年原发性高脂血症 ,既达到了显著降脂效果 ,又克服了大剂量应用时产生的副反应 ,不仅适用于高胆固醇血症 ,也适用于高甘油三?

Objective To evaluate the therapeutic effectiveness of low dose of simvastatin in the elderly patients with hyperlipidemia. Methods Simvastatin 5 mg per day was given to 62 hyperlipidemic patients and theofibrate 500 mg per day to 30 similar patients of the control group.Serum total cholesterol (TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),apoAI and apoB were examined before treatment and 4,8,12 weeks after treatment respectively.Results The observation showed that low dose of simvastatin could decrease not only serum TC,LDL and apoB levels greatly but also TG levels markedly.It could also increase serum HDL levels slightly but not apoAI levels.The decrease in levels of TC,LDL,apoB and TG ranged 25%～30%,27%～40%,25～34%,20%～36% respectively.The increase in HDL levels ranged from 0.48%～8.77%.Differences in the decrease in TC,LDL and apoB levels between the treatment group and the control group were significant while those in the increase in HDL and the decrease in TG were not.No marked adverse effects were seen in the treatment group whereas there were 3 patients with slight GPT elevation in the control group.Conclusion Low dose of simvastatin was a very effective and safe lipid lowering drug in elderly hyperlipidemia.