较大剂量阿托伐他汀治疗老年不稳定型心绞痛的疗效及安全性

The Study of Safety and Efficacy of Large Dosage Atorvastatin in Old Unstable Angina Patients

目的观察较大剂量阿托伐他汀(Acorvastatin)治疗老年不稳定型心绞痛(Unstable angina,UA)的安全性及有效性。方法选择我院老年不稳定型心绞痛患者153例,随机分为常规治疗组77例和较大剂量组76例,两组患者均给予常规治疗,常规剂量组在基础治疗外加用阿托伐他汀10mg,较大剂量组除基础治疗外加用阿托伐他汀40mg。共治疗观察90d。所有患者在治疗后第(30±3)d及(90±3)d进行实验室检查和不良事件评估。观察指标包括总胆固醇(TC),三酰甘油(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)。肝功能:天门冬氨酸氨基转移酶(AST),丙氨酸氨基转移酶(ALT),血尿素氮(BUN),血清肌酐(Scr),超敏C-反应蛋白(hs-CRP),纤维蛋白原(Fg)等。结果两组患者治疗前、后TC、TG、LDL-C、HDL-C、hs-CRP、Fg间差异均有显著性意义(P＜0．05),且两两比较两组患者治疗前与治疗后(30±3)d、(90±3)d时上述各项间差异亦均有显著性意义(P＜0．05)。整个研究过程中无死亡事件,不良反应轻微。结论应用较大剂量阿托伐他汀治疗老年不稳定型心绞痛安全性良好,抗炎、调脂效果更加显著。

Objective To observe the safety and efficacy of large dosage Atorvastatin in old Unstable angina （UA） patients. Methods The consecutive UA patients 153 cases who had accorded with study standards from May 2005 to May 2006 accepted the therapy of Atorvastatin, and examined some laboratory targets include total cholesterol （TC）, triglyceride （TG）, low density lipoprotein - cholesterol （ LDL - C ）, （ high density lipoprotein - cholesterol （ HDL - C ）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, blood urea nitrogen （BUN）, serum creatinine （Scr）, high sensitivity C reactive protein （ hs - CRP）, fibrinogen （Fg） and so on after 30 days and 90 days. Results The use of 10mg or 40mg Atorvastatin could obviously rise the level of HDL - C and reduced the levels of TC, TG, LDL - C and inflammatory factors （ hs - CRP, Fg） （ P 〈0. 05）. These effects were showed after 30 days in the group of using Atorvastatin in early admission period, and became more obviously after 90 days （ P 〈 0. 05）. Further more, the group of 40mg/d Atorvastatin had more benefit than the group of 10mg/d Atorvastatin in the follow - up periods （ P 〈 0.05 ）. Conclusion The use of larger dosage Atorvastatin seems safety and efficacy for old UA patients. The anti - inflammatory and lipid - lowering treatment were more marked.