不同剂量阿托伐他汀治疗老年人急性冠状动脉综合征临床疗效观察

Clinical effect of different doses of atorvastatin on elderly acute coronary syndrome

目的观察不同剂量阿托伐他汀治疗老年人急性冠状动脉综合征（ACS）的临床治疗效果。方法选择2010年1月至2012年1月我院心内科收治的老年ACS患者78例，随机分为阿托伐他汀治疗低剂量组和高剂量组，各39例。比较治疗前后患者三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—c）和高密度脂蛋白胆固醇（HDL—C）等指标的变化，记录治疗过程中不良反应的发生情况。结果治疗前，低剂量组和高剂量组TG、TC、LDL-C和HDL-C比较，差异无统计学意义（P〉0．05）。治疗1个月、3个月、6个月和12个月后，两组TC和LDL—C均有不同程度的降低，与治疗前比较差异均有统计学意义（P〈0．05），且高剂量组明显低于低剂量组，差异有统计学意义（P〈O．05）；治疗3个月、6个月和12个月后，两组TG均有不同程度的降低，与治疗前比较差异有统计学意义（P〈O．05），高剂量组低于低剂量组，差异有统计学意义（P〈0．05）；治疗1个月、3个月、6个月和12个月后，两组患者的HDL—C变化差异无统计学意义（P〉0．05）。低剂量组患者出现心血管事件的几率显著高于高剂量组（25．6％比10．3％），差异有统计学意义（P〈0．01）。低剂量组不良反应的发生率与高剂量组比较，差异无统计学意义（P〉0．05）。结论高剂量阿托伐他汀治疗老年人ACS的临床效果较好，能较好地降低患者血脂指标，而且能有效减少心血管事件发生率，安全性较好，值得临床应用。

Objective To observe the effect of different doses of atorvastatin in treating elderly acute coronary syndrome. Methods Totally 78 cases with acute coronary syndrome were randomly divided into two groups： low-dose atorvastatin group and high-dose atorvastatin group, 39 cases for each. The triacylglycerol （TG）, total cholesterol （TC）, low-density lipoprotein-cholestrol （LDL-C） and high-density lipoprotein-cholestrol （HDL-C） were compared between before and after the treatment. The adverse drug reactions were observed. Results Before treatment, the levels of TG, TC, LDLC and HDL-C were not statistic significant between the two groups. After treatment of 1 month, 3 months, 6 months and 12 months, TC and LDL-C of the two groups were decreased than those before treatment, and TC and LDL-C of high-dose atorvastatin group were lower than those of low-dose atorvastatin group, but HDL-C level was not changed compared with before treatment. After treatment of 3 months, 6 months and 12 months, TG levels of the two groups were decreased than those before treatment, and TG of high-dose atorvastatin group were reduced than those of low-dose atorvastatin group. The incidence rate of cardiovascular events of high-dose atorvastatin group was significantly lower than those of low-dose atorvastatin group. There was no difference in the incidence rate of adverse drug reactions between the two groups. Conclusions It＇s worthy to apply high-dose atorvastatin in clinical treatment for acute coronary syndrome because of its ability to decrease the levels of TG, TC, LDL-C, HDL-C and cardiovascular events.