他汀类药物对乙型肝炎病毒感染急性冠脉综合征患者肝功能的影响

Study of Liver Function in Patients with Statins for HBV Infection in Acute Coronary Syndrome

目的观察对乙型肝炎病毒(HBV)感染的急性冠脉综合征(ACS)患者应用瑞舒伐他汀钙或阿托伐他汀钙对肝功能的影响。方法选取2011年8月至2013年8月治疗的ACS患者80例,其中携带HBV的患者40例,不携带HBV的患者40例,在两组内按照随机数字表法各分为2组,共分成4组,每组20例。A组不携带HBV,使用阿托伐他汀钙治疗;B组不携带HBV,使用瑞舒伐他汀钙;C组携带HBV,使用阿托伐他汀钙治疗;D组携带HBV,使用瑞舒伐他汀钙治疗。收集两组患者治疗前和治疗6个月后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)的含量,以及ALT增长量超过3倍正常值上限(ULN)及以上的数据,并进行统计学分析。结果不携带HBV患者使用他汀类药物后肝功能较治疗前无明显差异;携带HBV患者使用他汀类药物后肝功能与治疗前相比差异明显(P<0.05);同种他汀类药物间比较,携带HBV患者比不携带HBV患者ALT及AST水平升高明显(P<0.05)。结论携带HBV ACS患者肝功能受他汀类药物影响较大,更易出现肝损伤,而瑞舒伐他汀钙和阿托伐他汀钙两种药物对ACS患者肝功能的影响并无明显差异。

Objective To study of HBV infection in patients with acute coronary syndrome （ACS） patients with rosuvastatin calcium or atorvastatin calcium in patients with liver function, as well as differences between the two drugs. Methods Selected ACS patients from August 2011 to August 2013 in our hospital, 80 cases, including 40 cases of HBV carrying the patient, do not carry the 40 cases of HBV patients, divided in two groups according to the random number table two groups, divided into four groups, 20 cases in each group. A group did not carry HBV used atorvastatin calcium therapy ASC patients in group B, to not carry HBV used rosuvastatin cal-cium, Group C for carrying HBV used atorvastatin calcium, D group for carrying HBV used Swiss rosuvastatin calcium. Patients were col-lected before treatment and after 6 months of treatment ALT, AST, TB, DB content, and ALT increase of more than 3ULN data and sta-tistical analysis. Results Did not carry HBV patients with no significant difference compared with pre - treatment liver function after use of statins. After carried the HBV patients used statins compared with pre - treatment liver function, data differences were significant, statistically significant（ P〈 0. 05）. The same kind of compared him among statins carry HBV patients than in patients not carrying the ALT HBV, AST data increased significantly, with statistical significance（ P〈 0. 05） . Conclusion Carry HBV liver function in patients receiving statins greater impact, are more vulnerable to liver damage, and rosuvastatin calcium and atorvastatin calcium are two drugs on liver function in patients with ASC do not differ significantly.