阿托伐他汀钙不同剂量治疗老年冠心病患者临床效果及安全性比较

Comparison of clinical efficacy and safety of atorvastatin calcium in different doses in the treatment of elderly patients with coronary heart disease

目的:探讨强化剂量与序贯剂量阿托伐他汀钙对老年冠心病患者的影响。方法:选取本院2021年1月-2022年11月收治的80例老年冠心病患者为研究对象,按照随机数字表法分为两组。对照组(n=40例)予以强化剂量阿托伐他汀钙治疗,40 mg/次,1次/d,连续服用12个月;观察组(n=40例)予以序贯剂量阿托伐他汀钙治疗,初始剂量为40 mg/次,1次/d,连续用药1个月,随后剂量减至20 mg/次,1次/d,共治疗12个月。比较两组心功能、血清学指标、炎症反应、生活质量、主要心脏不良事件及不良反应发生率。结果:治疗前,两组每搏输出量(SV)、心输出量(CO)、左室射血分数(LVEF)、高密度脂蛋白胆固醇(HDL-C)、左室舒张末期内径(LVEDD)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、丙氨酸氨基转移酶(ALT)、天门冬氨基酸转移酶(AST)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和各项生活质量综合评定问卷(GQOLI-74)指标比较无统计学差异(P>0.05);治疗后,两组SV、CO、LVEF、HDL-C以及各项GQOLI-74指标均较治疗前升高,且观察组高于对照组,两组LVEDD、LDL-C、TG、ALT、AST、CRP和TNF-α水平均较治疗前下降,且观察组低于对照组,具有统计学差异(P<0.05)。两组主要不良心脏事件发生率比较无统计学差异(P>0.05)。观察组不良反应发生率低于对照组,具有统计学差异(P<0.05)。结论:在老年冠心病患者中应用序贯剂量阿托伐他汀钙治疗效果更佳,可促进机体内血清学指标改善,减轻炎症反应,提高心功能,减少不良反应发生,改善生活质量。

Objective:To investigate the effects of intensive and sequential doses of atorvastatin calcium in elderly patients with coronary heart disease.Methods:Eighty elderly patients with coronary heart disease admitted to the Dexing Hospital of Traditional Chinese Medicine from January 2021 to November 2022 were selected as study subjects and divided into two groups according to the random number table method.The control group(40 patients)was treated with an intensive dose of atorvastatin calcium(40 mg/time)once daily for 12 months.The observation group(40 cases)was treated with atorvastatin calcium in sequential doses;the initial dose was 40 mg/time,once a day for one month,and then the dose was reduced to 20 mg/time,once a day for 12 months.The cardiac function,serological indices,inflammatory reaction,quality of life,major cardiac adverse events,and incidence of adverse reactions were compared between the two groups.Results:Before treatment,there were no statistically significant differences in stroke volume(SV),cardiac output(CO),left ventricular ejection fraction(LVEF),high-density lipoprotein cholesterol(HDL-C),left ventricular end-diastolic diameter(LVEDD),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α),or various quality of life assessment questionnaire(GQOLI-74)indicators between the two groups(P>0.05).After treatment,SV,CO,LVEF,HDL-C,and various GQOLI-74 indicators in both groups increased compared to those before treatment,and the observation group was higher than the control group.LVEDD,LDL-C,TG,ALT,AST,CRP,and TNF-αlevels in both groups decreased compared to those before treatment,and the observation group was lower than the control group,with statistical differences(P<0.05).There was no statistically significant difference in the incidence of major adverse cardiac events between the two groups(P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Sequential dose atorvastatin calcium therapy is more effective in elderly patients with coronary heart disease,promoting the improvement of serum indicators in the body,reducing inflammatory reactions,improving heart function,reducing adverse reactions,and improving the quality of life.