不同剂量氟伐他汀钠缓释片联合阿司匹林治疗冠心病合并高脂血症的临床疗效研究

Clinical Effect of Different Doses of Fluvastatin Sodium Extended- release Tablets on Coronary Heart Disease Complicated with Hyperlipidaemia Based on Aspirin

目的探讨不同剂量氟伐他汀钠缓释片联合阿司匹林治疗冠心病合并高脂血症的临床疗效。方法选取2013年3月—2014年8月济南市第四人民医院心内科收治的冠心病合并高脂血症患者150例,随机分为治疗组和对照组,每组75例。对照组患者给予小剂量(40 mg/次,1次/d)氟伐他汀钠缓释片联合阿司匹林肠溶片治疗;治疗组患者给予大剂量(80 mg/次,1次/d)氟伐他汀钠缓释片联合联合阿司匹林肠溶片治疗;8周为1个疗程,两组患者均治疗1个疗程后进行评价。比较两组患者治疗后心绞痛疗效、心电图疗效及不良反应发生情况,治疗前后血脂指标〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕及血肌酐、尿素氮、24 h尿蛋白定量、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)。结果治疗组患者心绞痛疗效及心电图疗效均优于对照组(P<0.05)。两组患者治疗前血清TC、TG、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05);治疗组患者治疗后血清TC、TG、LDL-C水平均低于对照组,血清HDL-C水平高于对照组(P<0.05)。治疗前两组患者血肌酐、尿素氮、24 h尿蛋白定量、ALT、AST比较,差异均无统计学意义(P>0.05);治疗后治疗组患者24 h尿蛋白定量高于对照组(P<0.05);治疗后两组患者血肌酐、尿素氮、ALT、AST比较,差异无统计学意义(P>0.05)。治疗组患者不良反应发生率为4%、对照组患者不良反应发生率为4%,差异无统计学意义(P>0.05)。结论大剂量(80 mg/d)氟伐他汀钠缓释片与阿司匹林联合治疗冠心病合并高脂血症的临床疗效确切,能有效改善患者的血脂指标,且安全性较高。

Objective To investigate the clinical effect of different doses of fluvastatin sodium extended - release tablets on coronary heart disease complicated with hyperlipidaemia based on aspirin. Methods From March 2013 to August 2014, a total of 150 coronary heart disease patients complicated-with hyperlipidaemia were selected in the Department of Cardiovascular Medicine, the Forth Hospital of Ji＇nan, and they were randomly divided into control group and treatment group, each of 75 cases. Based on aspirin, patients of control group received small duse of fluvastatin sodium extended - release tablets （40 mg per time, 1 time per day） , while patients of treatment group received large dose Of fluvastatin sodium extended - release tablets （80 mg per time, 1 time per day） ; both groups treated for 1 course （8 weeks as 1 course）. Clinical effect for angina pectoris, clinical effect for electrocardiogram, incidence of adverse reactions, blood lipids index （ including TC, TG, LDL-C and HDL-C）, serum creatinine, urea nitrogen, 24 h urinary protein, ALT and AST before and after treatment were compared between the two groups. Results Clinical effect for angina pectoris and clinical effect for electrocardiogram of treatment group were both statistically significantly better than those of control group （ P 〈 0. 05 ）. No statistically significant differences of serumlevel of TC, TG, LDL-C or HDL-C was found between the two groups before treatment （ P 〉 0. 05） ; after treatment, serum levels of TC, TG and LDL-C of treatment group were statistically significantly lower than those of control group, while serum HDL-C level of treatment group was statistically significantly higher than that of control group （ P 〈 0. 05 ）. No statistically significant differences of serum creatinine, urea nitrogen, 24 h urinary protein, ALT or AST was found between the two groups before treatment, nor was serum creatinine, urea nitrogen, ALT or AST between the two groups after treatment （ P 〉 0. 05 ）, while 24 h urinary protein of treatment group was statistically significantly higher than that of control group （ P 〈 0.05 ）. The incidence of adverse reactions of the two groups were both 4%, the difference was not statistically significantly different （ P 〉 0.05 ）. Conclusion Based on aspirin, large dose of fluvastatin sodium extended - release tablets （80 mg per time, l time per day） has better clinical effect in treating cbronary heart disease complicated with hyperlipidaemia, can effectively adjust the blood lipid metabolism, has higher safety.