辛伐他汀与血脂康用于高龄急性冠状动脉综合征患者调脂治疗的临床观察

Therapeutic effect of simvastatin and Xuezhikang on advanced age patients with acute coronary syndrome after antihyperlipemia therapy

目的探讨他汀类药物在高龄急性冠状动脉综合征(ACS)患者中应用的疗效及安全性。方法选择年龄≥75岁的ACS患者143例,随机分为辛伐他汀组73例和血脂康组70例。在冠状动脉粥样硬化性心脏病规范治疗的基础上,辛伐他汀组患者给予顿服辛伐他汀,每日20.0 mg;血脂康组患者给予口服血脂康0.6 g,每日2次,治疗1 a后随访,观察患者随访结束时不良反应及终点事件的发生情况。结果治疗前2组总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)及三酰甘油(TG)比较差异无统计学意义(P>0.05)。治疗后辛伐他汀组LDL-C低于血脂康组,差异有统计学意义(P<0.05);2组TC、HDL-C和TG比较差异无统计学意义(P>0.05)。2组治疗后BNP均较治疗前下降(P<0.05),但治疗前及治疗后2组间BNP比较,差异无统计学意义(P>0.05)。2组均无因不良反应而中断治疗的病例,且2组患者治疗1 a后终点事件发生率比较差异无统计学意义(P>0.05)。结论辛伐他汀和血脂康用于高龄ACS患者调脂治疗安全有效,且辛伐他汀调脂作用优于血脂康。

Objective To investigate the effect and security of statins on advanced age patients with acute coronary syndrome（ACS） after antihyperlipemia therapy.Methods One hundred and forty-three patients with ACS,more than 75 years old,were randomly divided into simvastatin group with 73 cases and Xuezhikang group with 70 cases.On the basis of standard therapy for coronary artery disease,the simvastatin group was given simvastatin 20 mg,once per day,while Xuezhikang group was given Xuezhikang 0.6 g,twice a day.All the patients were followed up for one year,the adverse effect and endpoint events were recorded.Results Before treatment,the difference of the total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C） and triacylglycerol（TG） was no statistical significance between the two groups（P〉0.05）.After treatment,LDL-C in simvastatin group was lower than that in the Xuezhikang group,the difference was statistical significance（P〈0.05）.The difference of TC,HDL-C and TG was no statistical significance between the two groups（P〉0.05）.After treatment,the B-type natriuretic peptide（BNP） in the two groups all decreased（P〈0.05）.There was no statistical significance in BNP before or after treatment between the two groups（P〉0.05）.No case stopped drug treatment due to adverse reaction;the difference of the endpoint events one year after treatment between the two groups was no statistical difference（P〉0.05）.Conclusion The effect of simvastatin and Xuezhikang on advanced age patients with ACS after antihyperlipemia therapy is effective and secure.And the effect of simvasatin is better than Xuezhikang.