不同他汀类药物对老年冠状动脉搭桥术患者的有效性与安全性

Efficacy and Safety of Different Statins in Older Patients Undergoing Coronary Artery Bypass Grafting

目的探究中等剂量的瑞舒伐他汀和辛伐他汀在对老年冠状动脉搭桥术患者的有效性与安全性。方法选取2015年3月~2017年3月108例接受冠状动脉搭桥术的老年患者进行回顾性分析,根据术后他汀类药物使用方案的不同分为两组,两组均接受二级预防药物治疗,瑞舒伐他汀组(58例)接受10 mg/d的瑞舒伐他汀治疗,辛伐他汀组(50例)接受20 mg/d的辛伐他汀治疗。比较两组入院时和术后1年的血脂水平、主要不良心血管事件(MACE)和安全性相关不良事件的发生情况。结果两组术后1年的血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均低于术前,高密度脂蛋白胆固醇(HDL-C)水平高于术前,差异均有统计学意义(P<0.05);两组患者术前和术后1年TC、LDL-C、HDL-C水平比较,差异均无统计学意义(P>0.05)。两组MACE、安全性相关不良事件比较,差异无统计学意义(P>0.05)。结论接受冠状动脉搭桥术后的老年冠心病患者,应用中等剂量的瑞舒伐他汀和辛伐他汀均可达到满意的降脂效果,两药的有效性和安全性没有差异。

Objective To investigate the efficacy and safety of moderate dose of rosuvastatin and simvastatin in older patients undergoing coronary artery bypass grafting.Methods A total of 108 older patients who underwent coronary artery bypass surgery from March 2015 to March 2017 were retrospectively analyzed.The patients were divided into two groups according to the postoperative statin use regimens,both groups received secondary preventive drug treatment.Rosuvastatin group(58 cases)received rosuvastatin 10 mg/d,and simvastatin group(50 cases)received simvastatin 20 mg/d.The lipid levels,major adverse cardiovascular events(MACE),and adverse events at admission and 1 year after surgery were compared between the two groups.Results The levels of total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the two groups 1 year after surgery were lower than those before surgery,and high-density lipoprotein cholesterol(HDL-C)level was higher than that before surgery,the differences were statistically significant(P<0.05).However,there were no significant differences in the levels of TC,LDL-C and HDL-C before and 1 year after surgery between rosuvastatin group and simvastatin group(P>0.05).There were no significant differences between the two groups in the incidence of MACE and safety-related adverse events(P>0.05).Conclusion In older patients with coronary heart disease who have undergone coronary artery bypass surgery,the application of moderate dose of rosuvastatin or simvastatin may effectively reduce the lipid levels,and there is no difference in the efficacy and safety between the two drugs.