不同剂量阿托伐他汀对比辛伐他汀治疗老年冠心病合并高脂血症的临床观察

Clinical Observation of Different Dose of Atorvastatin Versus Simvastatin in the Treatment of Coronary Heart Disease in Elderly Patients with Hyperlipidemia

目的:观察不同剂量阿托伐他汀对比辛伐他汀治疗老年冠心病合并高脂血症的临床疗效和安全性。方法:将150例老年冠心病合并高脂血症患者按随机数字表法均分为3组。观察Ⅰ组患者服用阿托伐他汀10 mg/d,qd;观察Ⅱ组患者服用阿托伐他汀20 mg/d,qd;对照组患者服用辛伐他汀20 mg/d,qd。8周为1个疗程,根据患者情况选择性治疗1～3个疗程。观察比较各组治疗前及治疗4、8周后的血脂水平[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、治疗8周后的总有效率以及治疗过程中的不良反应发生率。结果:治疗4周后,3组患者TC、TG、LDL-C、HDL-C水平均较治疗前显著改善(P<0.05),但组间比较差异无统计学意义(P>0.05);治疗8周后,3组患者TC、TG、LDL-C、HDL-C水平均较治疗前显著改善(P<0.05),且观察Ⅱ组患者TC、TG、LDL-C水平均显著低于观察Ⅰ组及对照组患者(P<0.05),而观察Ⅰ组患者各血脂指标与对照组患者比较差异均无统计学意义(P>0.05)。治疗8周后,观察Ⅱ组患者总有效率显著高于观察Ⅰ组及对照组患者(P<0.05),而观察Ⅰ组患者总有效率与对照组患者比较差异无统计学意义(P>0.05)。3组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:阿托伐他汀治疗老年冠心病合并高脂血症疗效较好,且对剂量有显著依赖性,适当增大剂量,治疗效果优于辛伐他汀,且不良反应发生率并不增加。

OBJECTIVE： To observe clinical efficacy and safety of different dose of atorvastatin vs. simvastalin in the treatment of coronary heart disease in elderly patients with hyperlipidemia. METHODS： 150 elderly patients with coronary heart disease com- plicating with hyperlipidemia were randomly divided into observation group I , observation group lI and control group with 50 cases in each group. Observation group I was given atorvastatin 10 mg/d once a day; observation group 11 was given atorvastatin 20 mg/d once a day half hour after a meal; control group was given simvastatin 20 mg/d half hour after supper. A treatment course lasted for 8 weeks, and the patients received one to 3 courses according to disease condition. Changes of blood lipid, total effective rate and the occurrence of ADR were compared between before treatment and 4 and 8 weeks after treatment, RESULTS： After 4 weeks of treatment, blood lipid levels of observation group I , observation group ]I and control group were decreased significant- ly than before （P〈0.05） ; there was no statistical significance among 3 groups （P〉0.05）. After 8 weeks of treatment, blood lipid levels of 3 group were decreased significantly （P〈0.05）, the level of TC, TG, LDL-C of observation group II was significantly lower than that of observation group I and control group （P〈0.05）, and there was no statistical significance of the blood lipid in observation group I and control group （P〉0.05）. After 8 weeks, the toatal effective rate of observation group lI was much high- er than that of observation group I and control group, there was no statistical significance among 3 groups. There was no statisti- cal significance in the incidence of ADR among 3 groups （P〉0.05）. CONCLUSIONS： Therapeutic efficacy of atorvastatin is bet- ter than that of simvastatin in the treatment of senile coronary heart disease complicating with hyperlipemia, and have obvious de- pendence on dose. The higher dose is, the more obvious effect is; the ADR has no change and the clinical effect is safe and stable.