不同剂量阿托伐他汀治疗老年冠心病患者的安全性及可行性分析

Analysis of the Feasibility and Safety of Different Doses of Atorvastatin in the Treatment of Elderly Patients with Coronary Artery Disease

目的对不同剂量阿托伐他汀治疗老年冠心病患者的安全性及可行性进行分析和探讨。方法选择2011年10月到2013年10月在本院进行治疗的老年冠心病患者68例,随机将其分为A组和B组两组各34例,A组患者在治疗中给予40 mg阿托伐他汀,B组患者在治疗中给予20 mg阿托伐他汀,在治疗过程中对两组患者的不良症状发生情况进行观察,并在治疗结束后对其血脂情况进行比较。结果经治疗后两组患者的HDL-C水平均有一定程度的升高,TG、TC以及LDL-C水平均有一定程度的下降,两组患者治疗前后相比差异具有统计学意义(均有P<0.05);治疗后两组患者相比A组HDL-C升高水平明显高于B组,且TG、TC以及LDL-C下降水平明显低于B组,两组相比差异具有统计学意义(均有P<0.05);在不良反应发生中,A组患者与B组患者表现ALT>3个正常上限(ULN)各1例,停药复查后恢复正常,发生率均为2.94%,两组发生率相比差异无统计学意义(P>0.05)。A组有6例患者在治疗1～2个月出现心绞痛症状,发生率为17.65%(6/34),B组有5例患者在治疗1～3个月出现心绞痛症状,发生率为14.71%(5/34),两组发生率相比差异无统计学意义(P>0.05)。结论大剂量阿托伐他汀应用于老年冠心病的治疗中疗效优于小剂量阿托伐他汀,且两种方式安全性无差异,故在临床治疗中建议采用大剂量给药。

Objective To analyze and discuss the feasibility and safety of different doses of atorvastatin in the treatment of elderly patients with coronary artery disease. Methods 68 elderly patients with coronary heart disease in our hospital from October 2011 to October 2013 were selected and randomly divided into two groups, with 34 cases in each group. Patients in the group A were treated with Atorvastatin 40 mg, while patients in group B were treated with Atorvastatin 20 mg. The complication during therapy and the blood fat after therapy were compared between two groups. Results After treatment, the HDL-C level increased, and TG, TC and LDL-C levels decreased in both group, and the differences were statistically significant （P〈0.05）;The differences of TG, TC and LDL-C after treatment between two groups were statistically significant （P 〈0.05）. Both groups had 1 case （2.94%） of ALT more than 3 times of upper limits of normal （ULN）, and both cases returned to normal after drug withdrawal. 6 cases （17.65%） of group A had symptom of angina pectoris at the first one to two months of treatment, while 5 cases （14.71%） of group B had symptom of angina pectoris at the first one to three months of treatment （P〉0.05）. Conclusions For elderly patients with coronary artery disease, the clinical effect of high dose of atorvastatin is better than that of small dose of atorvastatin, and there is no difference in the safety between two doses. So, we suggest high dose in clinic.