瑞舒伐他汀强化治疗外周动脉粥样硬化临床效用评价

Curative Effect of Rosuvastatin in Intensification Therapy of Peripheral Atherosclerosis

目的通过观察血脂变化及踝肱指数(ABI)情况,探讨瑞舒伐他汀强化治疗外周动脉粥样硬化的临床疗效。方法选取我院门诊就诊外周动脉粥样硬化133例,随机分为强化组65例和对照组68例。强化组在1～6个月采用瑞舒伐他汀20 mg/d强化治疗,第7～12个月采用10 mg/d常规治疗,对照组在第1～12个月均采用10 mg/d常规治疗。两组均于治疗前、治疗后1、3、6、12个月观察并记录血脂变化、踝肱指数情况。结果强化组在治疗后1、3、6、12个月低密度脂蛋白(LDL-C)、甘油三酯(TG)、总胆固醇(TC)均低于治疗前,高密度脂蛋白(HDL-C)高于治疗前,治疗后6个月LDL-C、TC低于治疗后1、3、12个月,HDL-C高于治疗后1、3、12个月(P<0.05)。强化组治疗后3、6个月TC低于对照组,治疗后6个月LDL-C低于对照组,HDL-C高于对照组(P<0.05,P<0.01)。对照组治疗后1、3、6、12个月,除治疗后1个月TC水平与治疗前比较无差异外,其他时间LDL-C、TG、TC水平均低于治疗前,HDL-C高于治疗前(P<0.05)。强化组治疗后6、12个月下肢动脉轻度病变比例以及ABI定量水平高于同组治疗前、治疗后1、3个月和对照组(P<0.05);两组均未发生肝功能异常及横纹肌溶解。结论瑞舒伐他汀可明显降低血清LDL-C、TG和TC,升高血清HDL-C。应用瑞舒伐他汀20 mg/d强化治疗外周动脉粥样硬化疗效较好,且安全性较高。

Objective To evaluate curative effect of rosuvastatin in intensification therapy of peripheral athero- sclerosis by observing changes of the level of blood lipid and the ankle brachial index （ABI）. Methods A total of 133 patients with peripheral atherosclerosis in our outpatient department, were divided into therapy group （n = 65 ） and control group （ n = 68）. Patients in therapy group were treated with rosuvastatin 20 mg/d for 1^st- 6^th months, and rosuvastatin 10 mg/d for 7^th -12^th months; While patients in control group were given rosavastatin 10 mg/d for 1^st -12^th months. Lipid levels and ABI were observed at 1^st, 3^th, 6^th and 12^th month before and after the treatment. Results Levels of LDL-C, TG and TC of therapy group at 1^st , 3^th , 6^th and 12^th month alter the treatment were significantly lower than those before treatment, while HDL-C level was higher than that before treatment, levels of LDL-C and TC at 6^th month after the treatment were significantly lower than those at 1^st, 3^th and 12^th month after the treatment, while HDL-C level was higher than those at 1^st, 3^th and 12^th month after the treatment, The TC levels in therapy group at 1^st and 3^th month after treatment were lower than those in control group, LDL-C level at 6^th month was lower than that in control group, while HDL-C level was higher than that in control group （P 〈0. 05 ,P 〈0. 01 ）. In control group levels of LDL-C, TG and TC at 3^th , 6^th and 12^th month after treatment were significantly lower than those before treatment, except there was no significant difference in TC level at 1 ^st month after treatment, while HDL-C levels after treatment were higher than those before treatment （P 〈 0. 05）; slight pathological changes in artery of lower extremity and ABI quantitation levels at 6^th and 12^th month after treatment in therapy group were significantly higher than those before treatment, and at 3^th and 6^th month after treatment in therapy group, and those in control group （P 〈 0.05 ）. There was no dysfunction of liver and rhabdomyolysis in the two groups. Conclusion Rosuvastatin may decrease serumal LDL-C, TG and TC, and heighten serumal HDL-C. Intensification therapy with rosuvastatin 20 mg/d may get better curative effect and more safety.