阿托伐他汀与瑞舒伐他汀治疗高龄冠心病和(或)2型糖尿病患者的疗效比较

Comparison on Efficacy of Atorvastatin and Rosuvastatin in Treatment of Elderly Coronary Heart Disease and( or) Type 2 Diabetes

目的：比较阿托伐他汀和瑞舒伐他汀治疗高龄冠心病和（或）2型糖尿病患者的疗效。方法：选择2014年1月—2015年3月在广州市第一人民医院老年科住院的高龄冠心病和（或）2型糖尿病患者130例作为研究对象,按随机数字表法分为2组各65例。A组患者应用阿托伐他汀进行治疗,服药剂量为10~40 mg/d,平均剂量为20 mg/d;B组患者应用瑞舒伐他汀进行治疗,服药剂量为5~20 mg/d,平均剂量为7.6 mg/d,2组患者疗程均为6个月,观察2组患者的血脂水平变化情况。结果：治疗后,2组患者的总胆固醇（TC）、甘油三脂（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）均较治疗前有所改善。其中,A组患者TC、LDL-C为（3.22±0.17）、（1.56±0.11）mmol/L,均明显优于治疗前的（3.73±0.15）、（1.97±0.12）mmol/L;B组患者的TC、LDL-C为（3.21±0.19）、（1.60±0.11）mmol/L,均明显优于治疗前的（3.84±0.21）、（1.98±0.12）mmol/L,差异均有统计学意义（P〈0.05）。治疗期间,A组1例患者出现急性心肌梗死,2例出现转氨酶升高;B组2例患者出现急性心肌梗死,2例出现转氨酶升高,2组的差异无统计学意义（P〉0.05）。结论：阿托伐他汀和瑞舒伐他汀均能够有效降低高龄冠心病和（或）2型糖尿病患者的TC和LDL-C,但在治疗过程中需密切监测患者的肝、肾功能及不良反应发生情况。

OBJECTIVE： To compare the efficacy of atorvastatin and rosuvastatin in treatment of elderly coronary heart disease and（ or） type 2 diabetes. METHODS： 130 patients with elderly coronary heart disease and（ or） type 2diabetes admitted into the geriatric department of the First People＇s Hospital of Guangzhou Medical University from Jan.2014 to Mar. 2015 were selected to be divided into group A and group B via the random number table,with 65 cases in each. Patients in group A were treated with atorvastatin,the dose of 10-40 mg / d and the average dose of 20 mg / d;and group B received rosuvastatin,the dose of 5-20 mg / d and the average dose of 7. 6 mg / d; the treatment course was6 months,and changes of blood lipid level in two group of patients were observed. RESULTS： After treatment,the total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterin（ LDL-C）,high density lipoprotein cholesterol（ HDL-C） of two group of patients were significantly decreased compared with before treatment. The TC and LDL-C of group A after treatment was（ 3. 22 ± 0. 17） and（ 1. 56 ± 0. 11） mmol / L,significantly higher than that of before treatment（ 3. 73 ± 0. 15） and（ 1. 97 ± 0. 12） mmol / L; meanwhile,the TC and LDL-C of group B after treatment was（ 3. 21 ± 0. 19） and（ 1. 60 ± 0. 11） mmol / L,significantly higher than that of before treatment（ 3. 84 ± 0. 21） and（ 1. 98 ± 0. 12） mmol/L,with statistically significant difference（ P〈0. 05）. During treatment,in group A,there was 1 case with acute myocardial infarction,2 cases with aminotransferase elevation; and in group B were respectively 2 cases with acute myocardial infarction and 2 cases with aminotransferase elevation; the difference was statistically significant（ P〉0. 05）. CONCLUSIONS： Atovastatin and rosuvastain can effectively decrease the TC and LDL-C of patients with elderly coronary heart disease（ or） type 2 diabetes,yet the liver and kidney function of patients and adverse drug reactions should be closely monitored during the treatment process.