80岁及其以上老年急性冠状动脉综合征住院患者他汀类药物使用状况调查

Investigation of statins in elderly patients ≥80 years of age with acute coronary syndrome

目的探讨≥80岁住院急性冠状动脉综合征(ACS)患者他汀使用及血清低密度脂蛋胆固醇(LDL-C)达标情况,以及他汀使用对≥80岁老年患者的安全性。方法收集2005年1月1日至2009年12月31日期间因ACS住院治疗的≥80岁的老年患者561例,按年份分析出院时他汀药物使用情况,以及血清LDL-C的达标率,并对使用他汀类药物产生的不良反应发生率进行统计。结果从2005年始,≥80岁老年ACS患者他汀使用率逐年升高,从2005年的49.4%上升到2009年的78.1%(P<0.01);LDL-C<2.59 mmol/L的达标率随着时间的推进呈逐渐上升趋势,但各年份之间差异无统计学意义(P>0.05);他汀类药物使用不良反应发生率为2.7%,以肝酶升高为主要表现(2.1%),大于3倍正常值者发生率仅为0.5%。结论≥80岁老年人合理应用他汀类药物是安全有效的,同时高龄老人使用他汀药物安全前提下强化降脂仍是必要的。

Objective To investigate the drug use and safety of statins in elderly patients ≥80 years of age with acute coronary syndrome（ACS）, and the condition of attainment of low density lipoprotein-cholesterol（LDL-C）. Methods 561 elderly patients ≥80 years of age with acute coronary syndrome hospitalized from 2005 to 2009 were included. According to different time limit, we analzed the drug use, safety of statins and the target LDL-C in elderly patients. Results From 2005 to 2009, usage of statins had the trend of rising（49.4%-78.2%, P 〈0.01）,the lipid target had the same trend（LDL-C〈2.59 mmol/L）, but the difference had no statistic significance（ P 〉0.05）, and the incidence rate of adverse effect was 2.7 %, elevated liver enzymes as the main performance （2.1%）, transaminase 3 times over normal value was only 0.5%. Conclusion Statins are safe and effective in elderly patients ≥80 years of age with ACS,but providing safe,intensive lipid lowering therapy is still necessary.