阿托伐他汀钙片对冠心病患者小而密低密度脂蛋白胆固醇水平的影响

Effect of atorvastatin calcium on small dense low density lipoprotein cholesterol in patients with coronary heart disease

目的探讨阿托伐他汀钙片对冠心病患者小而密低密度脂蛋白胆固醇(small dense low density lipoprotein cholesterol,sdLDL-C)表达水平的影响及sdLDL-C与冠心病的关系。方法将85例进行冠状动脉造影的冠心病患者按照检查结果分为狭窄组45例和非狭窄组40例。2组均给予阿托伐他汀钙20 mg,qd,睡前口服,治疗2周。采用全自动生化分析仪检测治疗前后患者生化指标及sdLDL-C水平,logistic逐步回归分析sdLDL-C与冠心病的关系。比较2组临床疗效、治疗前及治疗2周后sdLDL-C水平及药物不良反应发生率。结果治疗后,狭窄组和非狭窄组的总有效率分别为71.11%(32例/45例)和90.00%(36例/40例),差异有统计学意义(P<0.05)。治疗后,狭窄组和非狭窄组的sdLDL-C水平分别为(0.78±0.42)和(0.60±0.33)g·L^-1,差异有统计学意义(P<0.05)。经logistic逐步回归分析结果显示,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)、sdLDL-C、D-二聚体及纤维蛋白原(Fib)是冠心病发生冠状动脉狭窄的危险因素(P<0.05)。治疗期间,狭窄组出现恶心1例,腹胀1例,药物不良反应发生率为4.44%(2例/45例);非狭窄组出现恶心1例,药物不良反应发生率为2.50%(1例/40例)。2组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论冠心病患者sdLDL-C水平明显升高,sdLDL-C是冠心病发生冠状动脉狭窄的危险因素,阿托伐他汀钙可降低冠心病患者的sdLDL-C水平。

Objective To investigate the influence of atorvastatin calcium tablets on the expression level of small dense low density lipoprotein cholesterol(sdLDL-C)in patients with coronary heart disease(CHD)and the relationship between sdLDL-C and CHD.Methods A total of 85 CHD patients with coronary angiography were divided into stenosis group(45 cases)and non-stenosis group(40 cases).Both groups were given oral administration of atorvastatin calcium(20 mg),qd,before sleep for 2 weeks.The biochemical indexes and sdLDL-C level of patients before and after treatment were detected by automatic biochemical analyzer,and the relationship between sdLDL-C and coronary heart disease was analyzed by logistic stepwise regression.Clinical efficacy,sdLDL-C level before and 2 weeks after treatment and incidence of adverse drug reactions were compared in the 2 groups.Results After treatment,the total effective rates of the stenosis group and the non-stenosis group were 71.11%(32 cases/45 cases)and 90.00%(36 cases/40 cases),respectively,and the difference was statistically significant(P<0.05).After treatment,sdLDL-C levels in the stenosis group and the non-stenosis group were(0.78±0.42)and(0.60±0.33)g·L^-1,respectively,with statistically significant difference(P<0.05).Logistic stepwise regression analysis showed that total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),apolipoproteins B(apoB),sdLDL-C,D-dimer and fibrinogen(Fib)were risk factors for coronary artery stenosis in CHD(P<0.05).During the treatment,there was 1 case of nausea and 1 case of abdominal distension in the stenosis group,and the incidence of adverse drug reactions was 4.44%(2 cases/45 cases),while there was 1 case of nausea in the non-stenosis group,and the incidence of adverse drug reactions was 2.50%(1 case/40 cases).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion sdLDL-C level significantly increased in CHD patients,indicating that sdLDL-C is a risk factor for coronary artery stenosis in CHD,and atorvastatin calcium can reduce sdLDL-C level in CHD patients.