老年冠心病接受支架置入患者治疗中序贯与强化剂量阿托伐他汀对临床疗效及血清学指标的影响

Influence of atorvastatin in sequential and intensive doses on clinical efficacy and serum indexes in elderly patients with coronary heart disease received stent implantation

目的研究老年冠状动脉粥样硬化性心脏病(冠心病)接受支架置入患者治疗中序贯与强化剂量阿托伐他汀对临床疗效及血清学指标的影响。方法选取2015年3月至2016年4月于临沂市人民医院就诊的老年冠心病患者177例作为研究对象,所有患者均首次接受支架置入。按随机数字表法将所有患者分为对照组(n=88)和研究组(n=89)。其中对照组患者给予阿托伐他汀强化剂量治疗,研究组患者给予阿托伐他汀序贯剂量治疗。对比两组患者治疗前后血压水平、射血分数(EF)、血清学指标,治疗后12个月时主要心脏不良事件(MACE),治疗后12个月时冠状动脉(冠脉)造影结果及治疗期间内不良反应。结果两组患者收缩压(SBP)和舒张压(DBP)均明显低于治疗前,EF明显高于各自治疗前,且均有统计学差异(P<0.05)。两组患者治疗后1个月和治疗后12个月的三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均明显低于各自治疗前,治疗后12个月的TG、LDL-C均明显低于各自治疗后1个月,研究组患者治疗后12个月的TG、LDL-C均明显高于对照组,且均有统计学差异(P<0.05)。两组患者对比治疗后12个月的MACE发生均无统计学差异(P>0.05)。两组患者治疗后12个月的冠脉造影结果对比无统计学差异(P>0.05)。随访12个月期间内,无新发糖尿病、肌痛等并发症发生,无肝酶异常。结论老年冠心病接受支架置入患者治疗过程中,序贯剂量与强化剂量在血压水平、射血分数、血清学指标、MACE和冠脉造影方面无明显差异,且序贯剂量可减少服药数量,优化药物治疗,值得临床推广。

Objective To study the influence of atorvastatin in sequential and intensive doses on clinical efficacy and serum indexes in elderly patients with coronary heart disease (CHD) received stent implantation. Methods The elderly CHD patients (n=177) were chosen from People's Hospital of Linyi City from Mar. 2015 to Apr. 2016,and all patients were received first-time stent implantation. All patients were divided,according to random digital table,into control group (n=88) and study group (n=89). The control group was given atorvastatin in intensive dose and study group was given atorvastatin in sequential dose. The levels of blood pressure (BP),ejection fraction (EF) and serum indexes were compared between 2 groups. The incidence of major adverse cardiovascular events (MACE),results of coronary angiography (CAG) and adverse reactions during treatment period were compared between 2 groups 12 months after treatment. Results The levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower and EF was significantly higher in 2 groups after treatment (P<0.05). The levels of TG and LDL-C were significantly lower in 2 groups 1 month and 12 months after treatment, and were significantly lower in 2 groups after 12 months than those after 1 month. The levels of TG and LDL-C were significantly higher in study group than those in control group 12 months after treatment (P<0.05). The incidence of MACE had no statistical difference between 2 groups 12 months after treatment (P>0.05). The results of CAG had no statistical difference between 2 groups 12 months after treatment (P>0.05). There were no new-attack diabetes, myalgia and liver-enzyme abnormalities observed during follow-up period for 12 months. Conclusion Atorvastatin in sequential and intensive doses have no significant difference in effects on levels of BP,EF and serum indexes and results of MACE and CAG,while atorvastatin in sequential dose can reduce drug quantity and optimize medication in elderly CHD patients received stent implantation,which is worth clinical promoting.