阿托伐他汀与辛伐他汀治疗冠心病心绞痛的疗效与安全性比较

Comparison of therapeutic effect and safety between atorvastatin and simvastatin in patients with angina pectoris of coronary heart disease

目的:比较阿托伐他汀与辛伐他汀治疗冠心病心绞痛的疗效及安全性。方法:选择冠心病慢性稳定型心绞痛患者150例,按数字表法被随机均分成阿托伐他汀组和辛伐他汀组。比较治疗前后两组间心绞痛发作次数、持续时间、疼痛程度、硝酸甘油用量差异及血脂变化,随访6个月,统计心血管事件发生率差异。结果:与治疗前比较,治疗12周后两组患者的心绞痛发作次数与硝酸甘油用量明显减少,每次持续时间缩短,疼痛程度明显减轻(P均<0.05);但两组间治疗前及治疗后上述指标比较均无统计学差异(P均>0.05)。与治疗前相比,治疗后阿托伐他汀组和辛伐他汀组患者的血清总胆固醇[(5.62±0.54)mmol/L比(3.68±0.41)mmol/L,(5.78±0.56)mmol/L比(3.33±0.43)mmol/L]、甘油三酯[(2.30±0.42)mmol/L比(1.62±0.34)mmol/L,(2.35±0.41)mmol/L比(1.68±0.69)mmol/L]、低密度脂蛋白胆固醇[(3.56±1.22)mmol/L比(2.76±0.83)mmol/L,(3.48±1.21)mmol/L比(2.43±0.72)mmol/L]显著下降,高密度脂蛋白胆固醇[(1.32±0.35)mmol/L比(1.58±0.34)mmol/L,(1.30±0.46)mmol/L比(1.60±0.45)mmol/L]水平则显著上升(P均<0.05),治疗后两组间血脂水平无明显差异(P>0.05);随访期间两组间心血管事件发生率无明显差异(28.00%比25.33%,P>0.05)。结论:阿托伐他汀与辛伐他汀均能有效调节高血脂状态,治疗冠心病心绞痛疗效好,安全性高。

Objective：To compare therapeutic effect and safety between atorvastatin and simvastatin treating angina pectoris of coronary heart disease （CHD）.Methods：A total of 150 patients with chronic stable angina pectoris （SAP）of CHD were selected and randomly and equally divided into atorvastatin group and simvastatin group according to number table method.Changes of angina pectoris attack frequency,duration,degree of pain,nitroglycerin dosage and blood lipids were compared between two groups before and after treatment.All patients were followed up six months.Results：Compared with before treatment,there were significant reductions in angina pectoris attack frequency,duration,pain degree and nitroglycerin dosage after treatment 12 weeks in two groups,P〈0.05 all;but there were no significant difference in above indexes between two groups before and after treatment （P〉0.05 all）. Compared with before treatment,there were significant reductions in serum levels of total cholesterol [ （5.62 ± 0.54）mmol/L vs.（3.68±0.41）mmol/L,（5.78±0.56）mmol/L vs.（3.33±0.43）mmol/L],triglyceride [（2.30 ±0.42）mmol/L vs.（1.62±0.34）mmol/L,（2.35±0.41）mmol/L vs.（1.68±0.69）mmol/L]and low density lipoprotein cholesterol [（3.56±1.22）mmol/L vs.（2.76±0.83）mmol/L,（3.48±1.21）mmol/L vs.（2.43± 0.72）mmol/L],and significant increase in level of high density lipoprotein cholesterol [（1.32±0.35）mmol/L vs. （1.58±0.34）mmol/L,（1.30±0.46）mmol/L vs.（1.60±0.45）mmol/L]in atorvastatin group and simvastatin group after treatment （P〈0.05 all）,but there were no significant difference in blood lipid levels between two groups after treatment （P〉0.05）;there was no significant difference in incidence rate of cardiovascular events （28.00% vs.25.33%,P〉0.05）between two groups during follow-up.Conclusion：Both atorvastatin and simvastatin can effectively regulate the state of high blood lipid,and possess good effect and safety for angina pectoris of coronary heart disease.