老年冠心病患者服用他汀类调脂药物单中心横断面分析

A single center sectional analysis of statins used in elderly coronary heart disease patients

目的分析老年冠心病患者他汀类调脂药物使用情况。方法回顾我科2011年11月～2014年12月入院的冠心病患者病历资料2252例，根据年龄分为≥75岁组243例，60-74岁组2009例，比较2组入院前他汀类药物使用情况；剔除不能提供所使用他汀类药物种类或剂量的病例，≥75岁组剩余95例，60～74岁组剩余811例，统计不同种类他汀类药物及剂量在2组患者中的应用比例。结果≥75岁组高血压、2型糖尿病比例明显高于60～74岁组（75．3％vs66．7％、39．9％vs28．3％，P〈0．01）。≥75岁组氟伐他汀和普伐他汀使用比例显著高于60～74岁组（6．3％VS1．7％、8．4％vs3．1％，P〈0．05），阿托伐他汀使用比例显著低于60～74岁组（42．1％vs53．3％，P〈0．05）。≥75岁组与60～74岁组瑞舒伐他汀、辛伐他汀、洛伐他汀及匹伐他汀使用比例无明显差异（15．8％us14．4％、24．2％vs26．2％、1．1％VS0．6％、2．1％vs0．7％，P〉0．05）。结论临床医师在为老年患者制定调脂药物治疗方案时，应兼顾疗效与药物不良反应，为老年患者带来最大的临床获益。

Objective To analyze the use of statins in elderly coronary heart disease （CHD） patients. Methods A total of 2252 elderly CHD patients admitted to our hospital from November 2011 to December 2014 were divided into ≥75 years old group （n=243） and 60-74 years old group （n= 2009）. Their medical history data were retrospectively analyzed. Statins used in the patients before they were admitted were compared. Different statins and their doses used in two groups were recorded. Results The incidence of hypertension and type 2 diabetes mellitus was significantly higher in ≥75 years old group than in 60-74 years old group （75.3% vs 66.7%, 39.9$ vs 28.3% ,P〈0.01）. The rate of fluvastatin and pravastatin used in ≥75 years old group was significantly higher than that used in 60-74 years old group （6. 3% vs 1. 7%, 8. 4% vs 3.1 % ,P〈0.05） while the rate of atorvastatin used in ≥75 years old group was significantly lower than that used in 60-74 years old group （42.1% vs 53.3%,P〈0.05）. No significant difference was found in the use of rosuvastatin, simvastatin, lovastatin and pitavastatin between the two groups （P〉0.05）. Conclusion Clinicians should take the therapeutic effect and adverse effect of statins into account when they make treatment plans for elderly patients.