瑞舒伐他汀的不同用药方式在高龄血脂异常患者中的疗效观察

Therapeutic effect of different rosuvastatin regimens on elderly patients with dyslipidemia

目的比较瑞舒伐他汀的不同用药方式在高龄血脂异常患者中的疗效及患者依从性。方法选取2017年2月至10月于唐山工人医院就诊的168例年龄≥75岁的高龄血脂异常患者作为本次研究对象。将患者随机分为每日服药组与隔日服药组。每日服药组给予患者口服瑞舒伐他汀10 mg/d,隔日服药组给予患者口服瑞舒伐他汀10 mg/隔日。检测每日服药组与隔日服药组用药前及用药6月后患者的血清总胆固醇(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)及外周血脂蛋白相关性磷脂酶A2(Lp-PLA2)的水平,分别计算两组患者LDL-C变化率、LDL-C达标率及Lp-PLA2变化率;记录两组患者中发生不良反应的类型及人数;并对比、分析每日服药组与隔日服药组患者的依从性。结果试验开始时共168例患者参与本研究,年龄在75～89岁,平均(78.26±2.98)岁,试验结束时有49例患者因依从性差被排除,最终有119例患者完成了本试验,其中每日服药组52例患者(n=52),隔日服药组67例患者(n=67)。瑞舒伐他汀治疗6月后,两组患者的TC、TG及LDL-C水平较用药前均有明显降低,差异有统计学意义(P<0.05);每日服药组LDL-C下降35.96%,隔日服药组LDL-C下降32.68%,差异无统计学意义(P>0.05);每日服药组与隔日服药组口服瑞舒伐他汀治疗6个月后LDL-C达标率分别为76.9%、71.6%,但差异无统计学意义(P>0.05)。每日服药组与隔日服药组外周血Lp-PLA2水平分别降低了57.81%、57.37%,差异无统计学意义(P>0.05)。每日服药组中患者依从性好者占61.90%(52/84例),隔日服药组中依从性好者占79.76%(67/84例),差异有统计学意义(P<0.05)。结论隔日服用瑞舒伐他汀与每日服用瑞舒伐他汀在降低LDL-C及Lp-PLA2水平方面取得了类似的效果,并且隔日服用瑞舒伐他汀较每日用药减少了费用,提高了患者的用药依从性。

Objective To compare the efficacy and compliance of different rosuvastatin regimens in elderly patients with dyslipidemia.Methods A total of 168 elderly patients with dyslipidemia who aged 75 years and over cared at Tangshan Gongren Hospital from February 2017 to October 2017 were included in this study.The patients were randomly divided into daily medication group and every-other-day medication group.The daily medication group was initiated on 10mg rosuvastatin daily and every-other-day medication group was given rosuvastatin 10 mg every other day.The serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL)and peripheral blood lipoprotein-related phospholipase A2(Lp-PLA2)levels were examined before and after the treatment which lasted for at least 6 months in the daily and daily medication groups.The change rate of LDL-C,the rate of LDL-C reach target goal and the change rate of Lp-PLA2 in the two groups of patients were calculated.The number of adverse reactions and the types of adverse reactions in the two groups were recorded.A comparison and analysis was made on the compliance of the daily medication group and the every-other-day medication group.Results A total of 168 patients were enrolled in the study at the start of the study,aged 75~89 years,mean(78.26±2.98)years old.At the end of the trial,49 patients were excluded due to poor compliance,and finally 119 patients completed the trial.There were 52 patients in the daily medication group(n=52)and 67 patients in the medication group every other day(n=67).After 6 months of rosuvastatin treatment,the levels of TC,TG and LDL-C in the two groups were significantly lower than those before administration(P<0.05).The daily dose of LDL-C decreased by 35.96%.LDL-C decreased by 32.68%every other day,and the difference was not statistically significant(P>0.05).The LDL-C compliance rate was 76.9%after 6 months of oral rosuvastatin treatment in the daily medication group and the next day.71.6%,but the difference was not statistically significant(P>0.05).The peripheral blood Lp-PLA2 levels in the daily medication group and the next day medication group decreased by 57.81%and 57.37%,respectively,and the difference was not statistically significant(P>0.05).Among the patients in the daily medication group,61.90%(52/84 cases)had good compliance,and 79.76%(67/84 cases)had good compliance in the next day.The difference was statistically significant(P<0.05).Conclusions Taking rosuvastatin every other day and rosuvastatin daily have similar effects in lowering LDL-C and Lp-PLA2 levels,and taking rosuvastatin every other day reduces the cost and improves the patient's Medication compliance.