他汀类药物对老老年冠心病患者的应用分析

The analysis of statins using in the elderly patients with coronary heart disease

目的 研究他汀类药物对80岁以上老老年冠心病患者的疗效及安全性.方法 入选73例80岁以上冠心病患者,入院后给予他汀类药物调脂治疗.按他汀药物不同,分为辛伐他汀组（20 mg/d）27例、阿托伐他汀组（20 mg/d）32例和瑞舒伐他汀组（5 mg/d）14例,分别对比分析用药前及随访12～24（13.8±3.7）个月后血脂参数和安全性指标,以及三组患者治疗后各指标的变化.结果 ①冠心病患者治疗后较治疗前TC、LDL-C、LDL-C/HDL-C均有明显下降[（3.59±0.67） mmol/L比（3.84±0.91） mmol/L、（2.16±0.61）mmol/L比（2.39±0.78）mmol/L及（2.15±0.75）比（2.48±0.85）],差异有统计学意义（P＜0.05）;治疗后较治疗前肝功、肾功、肌酶差异无统计学意义.②三组间调脂疗效无显著差异,并且肝功、肾功、肌酶等指标差异无统计学意义.结论 对于80岁以上老老年冠心病患者,应用常规剂量的他汀类药物调脂疗效好,不良反应少,安全性良好.

Objective To study the influence and safety of statins in the 80 older patients with coronary heart disease. Methods Selected 73 cases over 80 years in patients with coronary heart disease, according to the statin drugs, divided into 27 cases of the simvastatin group （20 rag/d）, 32 cases of atorvastatin group（20 rag/d）, and 14 cases of rosuvastatin group （5 mg/d）, the blood-Lipid parameters and safety indicators were monitored be- fore treatment and follow-up 12-24 （mean 13.8±3.7 ） months in all the patients. The lipid level and other lab tests were compared in three groups, and compared before and after treatment. Results （1）The variation of TC, LDL- C, LDL-C/HDL-C was obvious before and after treatment [（3.59±0.67）mmol/L vs （3.84±0.91）mmol/L, （2.16± 0.61 ）mmoi/L vs （2.39±0.78）retool/L, （2.15±0.75） vs （2.48±0.85） ] （P〈O.05）, and the difference was significant in statistics, the adverse reactions before and after treatment was fewness and the security was fine. （2）The variation of the blood-Lipid parameters and safety indicators after treatment in simvastatin group, the atorvastatin group and rosuvastatin group was not significant in statistics. Conclusion Statins use in the elderly （over 80 years） patients with coronary heart disease is effective and safe.