他汀使用依从性对冠状动脉粥样硬化患者血脂及心血管事件的影响

Effect of compliance of statins on blood lipid and cardiovascular events in patients with coronary atherosclerosis

【目的】评估冠状动脉粥样硬化患者他汀药物应用的依从性及对血脂和心血管事件的影响。【方法】连续选取经CT冠脉造影检测诊断为冠状动脉粥样硬化100名患者,经随访根据其他汀用药方式分为三组[中断组(n=32),间断组(n=39),持续组(n=29)],观察不同用药组的血脂改变及其心血管事件的发生的结果,以及他汀应用方式与心血管事件的关系。【结果】所有患者最少1年的随访中只有29%能坚持应用他汀,持续用药组具有明显的降低低密度脂蛋白的作用(P<0.001)和升高高密度脂蛋白的作用(P<0.001)。持续他汀使用是主要不良心血管事件(the main adverse cardiovascular events,MACE)发生的独立保护因素(P=0.005)。【结论】对于冠状动脉粥样硬化患者他汀药物应用依从性较低,不利于血脂低密度脂蛋白的控制,加强随访期的管理提高他汀的用药依从性可能有益于冠心病的1级预防。

【Objective】To evaluate the compliance of statins in patients with atherosclerosis and its effect on blood lipid and cardiovascular events.【Methods】A total of 100 patients with coronaryatherosclerosis diagnosed by coronary CT were divided into three groups(interrupt group,n=32;intermittent group,n=39;continuous group,n=29),according to the medication modes of statins by follow-up.The changes of blood lipid and cardiovascular events in different drug groups were observed,and the relationship between the compliance of statins and cardiovascular events were analyzed.【Results】Only 29%of all patients with at least one year follow-up were able to adhere to statins,and there was a significant effect on reducing LDL level in the continuous group(P<0.001)and increasing HDL level(P<0.001).Continuous use ofstatins was an independent protective factor for cardiovascular events(P=0.005).【Conclusion】For patients with coronary atherosclerosis,the application compliance of statins is low,which is not good for the control of low-density lipoprotein(LDL).Strengthening the management of follow-up period to improve drug compliance of statins may be beneficial to the primary prevention of coronary heart disease.