阿托伐他汀与瑞舒伐他汀治疗冠心病合并慢性肾脏疾病3期的效果比较

Effect comparison of atorvastatin and rosuvastatin in the treatment of coronary heart disease combining with third-stage chronic renal disease

目的比较阿托伐他汀与瑞舒伐他汀治疗冠心病合并慢性肾脏疾病3期的效果。方法选择2009年1月~2012年1月本院收治的100例冠心病合并慢性肾脏疾病3期患者,将其随机分为实验组和对照组,每组50例。实验组应用阿托伐他汀治疗,对照组应用瑞舒伐他汀治疗,保证两组患者血脂控制均达标,同时均给予规范冠心病Ⅱ级预防用药,保证血压、血糖等危险因素控制达标,观察两组患者治疗3年后的差异。结果实验组的肌酐清除率下降率为22%,低于对照组的54%（P〈0.01）;实验组的新增蛋白尿发生率为18%,低于对照组的40%（P〈0.05）,但两组的急性心肌梗死发生率差异无统计学意义（P〉0.05）,且均未发生猝死。结论与瑞舒伐他汀比较,阿托伐他汀对肾损害更小,是治疗冠心病合并慢性肾脏疾病3期更好的选择。

Objective To compare the effect of atorvastatin and rosuvastatin in the treatment of coronary heart disease combining with third-stage chronic renal disease. Methods 100 patients with coronary heart disease combining with third-stage chronic renal disease admitted into our hospital From January 2009 to January 2012 were selected and randomly divided into experimental group and control group,50 cases in each group.In experimental group,atorvastatin was applied, while in control group,rosuvastatin was used.The therapeutic difference after 3 years treatment was observed at premises of ensuring blood lipid control reaching the standard as well as blood pressure and blood glucose provided with stan- dard second-level preventiondrug for coronary heart disease. Results The decrease rate of creatinine clearance rate in the experimental group was 22%,which was lower than 54% of control group （P〈0.01）.The incidence of newly-occurred proteinuria in the experimental group was 18%,which was lower than 40% of control group（P〈0.05）.There was no statis- tical difference in the incidence of acute myocardial infarction in the two groups（P〉0.05）,and no sudden death case oc- curred in two groups. Conclusion Compared with rosuvastatin, the renal damage by atorvastatin is slighter,which is the better choice in the treatment of coronary heart disease combining with third-stage chronic renal disease