阿托伐他汀钙与辛伐他汀治疗原发性高脂血症临床随机对照研究

Comparison of Atorvastatin Calcium and Simvastatin in Treating Primary Hyperlipidemia

目的探讨阿托伐他汀钙治疗原发性高脂血症患者的临床疗效及对血脂水平的影响。方法选择2014年1月至2016年1月经医院诊断为原发性高脂血症的住院患者100例,按随机数字表法分为对照组(辛伐他汀,每次20 mg,每日1次)与治疗组(阿托伐他汀钙,每次20 mg,每日1次),各50例。比较两组患者临床疗效及不良反应发生情况,并比较两组患者治疗前后血脂水平[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]和肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、肌酸激酶(CK)]变化。结果治疗组治疗后血清TG,TC,LDL-C水平分别为(2.61±0.38)mmol/L,(1.51±0.42)mmol/L,(1.99±0.35)mmol/L,明显低于对照组的(4.96±0.42)mmol/L,(2.14±0.51)mmol/L,(3.11±0.37)mmol/L(t=29.33,6.74,15.54;P=0.00,0.00,0.00);治疗后,治疗组HDL-C为(2.23±0.79)mmol/L,明显高于对照组的(1.32±0.69)mmol/L(t=6.13,P=0.00);治疗前,两组患者肝功能指标AST,ALT及CK水平比较,差异无统计学意义(t=0.05,0.51,0.17;P=0.95,0.60,0.86);两组患者肝功能指标治疗后较治疗前无明显变化(t=0.43,0.99,0.25;P=0.66,0.32,0.79);治疗组治疗总有效率为94.00%,明显高于对照组的74.00%(χ~2=7.74,P=0.02)。结论阿托伐他汀钙片治疗原发性高脂血症患者较辛伐他汀片疗效更显著,可显著改善患者血脂水平,安全性高,值得临床推广。

Objective To investigate the clinical efficacy of Atorvastatin Calcium in treating primary hyperlipidemia,and its influence on serum TC,TG,LDL-C and HDL-C.Methods Totally 100 patients with primary hyperlipidemia admitted to the hospital from January2014 to January 2016 were selected and randomly divided into the control group（Simvastatin treatment,20 mg/time,1 time/d） and the treatment group（Atorvastatin Calcium treatment,20 mg/time,1 time/d）.The clinical efficacy and adverse reactions of the two groups were recorded.The blood lipid（TC, TG, LDL-C, HDL-C） and liver function（AST, ALT, CK） were detected before and after treatment in the two groups.Results The levels of serum TG,TC and LDL-C in the treatment group were（2.61 ± 0.38） mmol/L,（1.51 ± 0.42） mmol/L and（1.99 ± 0.35） mmol/L, respectively, which were significantly lower than（4.96 ± 0.42） mmol/L,（2.14 ± 0.51） mmol/L,（3.11 ±0.37） mmol/L in the control group（t = 29.33,6.74,15.54, P = 0.00,0.00,0.00）.After treatment,the levels of HDL-C in the treatment group was（2.23 ± 0.79） mmol/L, which was significantly higher than（1.32 ± 0.69） mmol/L of the control group（t = 6.13, P =0.00）.Before treatment, the AST, ALT and CK levels in the two groups had no significant difference（t = 0.05, 0.51,0.17, P = 0.95,0.60,0.86）,and there was no significant difference between the two groups before and after treatment（t = 0.43,0.99,0.25, P = 0.66,0.32, 0.79）.The total effective rate of the treatment group was 94.00%, which was significantly higher than 74.00% of the control group（χ~2= 7.74, P = 0.02）.Conclusion Compared with Simvastatin, Atorvastatin Calcium in the treatment of patients with primary hyperlipidemia has significant efficacy, and can significantly improve patient blood lipid levels with high safety, which can be recommended as the first choice for clinical treatment.