阿托伐他汀和瑞舒伐他汀治疗老年冠心病患者的疗效比较
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摘要
目的:探讨阿托伐他汀和瑞舒伐他汀治疗老年冠心病(CHD)患者的疗效差异,为临床优化治疗提供参考依据。方法:选取我院2015年3月至2017年9月期间收治的180例老年CHD患者,年龄均≥65岁,且均经过冠状动脉造影(CAG)确诊,采用随机数表法将其分为对照组和观察组,两组各90例。常规治疗基础上,对照组口服阿托伐他汀,20mg/次,1次/d,观察组口服瑞舒伐他汀,10mg/次,1次/d,均持续治疗6个月。分别检测两组CHD患者甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)和低密度脂蛋白胆固醇(LDL-C)变化,观察超敏C反应蛋白(hs-CRP)、肱动脉血流介导的舒张功能(FMD),统计两组治疗期间的不良反应情况。结果:两组均谨遵医嘱完成治疗,无中退退出或脱落病例。观察组治疗后血脂指标TG、TC、LDL-C较治疗前、对照组治疗后均有显著下降,HDL-C明显升高(P<0.05);观察组治疗后血清hs-CRP较治疗前、对照组治疗后显著下降,FMD明显升高(P<0.05);两组治疗均较为平稳,仅出现少量轻微不良症状,观察组不良反应率8.89%(8/90)低于对照组11.11%(10/90),但两者差异无统计学意义(P>0.05)。结论:阿托伐他汀和瑞舒伐他汀均是临床治疗老年CHD的安全有效药物,但瑞舒伐他汀调脂、抑制炎症反应和改善血管内皮功能的效果显著更优。
Objective: To explore the difference of efficacy between atorvastatin and rosuvastatin in the treatment of elderly patients with coronary heart disease( CHD),and to provide reference for clinical optimization of treatment. Methods: 180 elderly patients with CHD were treated in our hospital from March 2015 ～2017 to September. The age was more than 65 years old,and all were confirmed by coronary angiography( CAG). The patients were divided into the control group and the observation group by the random number table method,and the 2 groups were 90 cases each. On the basis of routine treatment,the control group took atorvastatin,20 mg/times,1 times/d,and the observation group took rosuvastatin,10 mg/times and 1 times/d for 6 months. The changes of triglyceride( TG),total cholesterol( TC),high density lipoprotein( HDLC) and low density lipoprotein cholesterol( LDL-C) were detected in 2 groups of CHD patients. The hypersensitive C reactive protein( hs-CRP) and brachial artery blood flow mediated diastolic function( FMD) were observed,and the adverse reactions of the 2 groups were statistically analyzed. Results: The 2 groups completed the treatment according to the doctor's advice,without withdrawal or falling off. After treatment,the blood lipid index TG,TC and LDL-C in the observation group were significantly lower than those in the control group and the control group( P <0.05). The serum hs-CRP in the observation group decreased significantly after treatment,and the FMD increased significantly( P <0.05) after treatment. The 2 groups were all stable and only a small amount of minor adverse symptoms appeared. The adverse reaction rate of the observation group was 8.89%( 8/90),which was lower than that of the control group 11.11%( 10/90),but the difference between the 2 groups was not statistically significant( P >0.05). Conclusion: Atorvastatin and rosuvastatin are both safe and effective drugs for the treatment of elderly CHD,but rosuvastatin has better effects on lipid regulation,inhibition of inflammatory reaction and improvement of vascular endothelial function.
Objective: To explore the difference of efficacy between atorvastatin and rosuvastatin in the treatment of elderly patients with coronary heart disease( CHD),and to provide reference for clinical optimization of treatment. Methods: 180 elderly patients with CHD were treated in our hospital from March 2015 ～2017 to September. The age was more than 65 years old,and all were confirmed by coronary angiography( CAG). The patients were divided into the control group and the observation group by the random number table method,and the 2 groups were 90 cases each. On the basis of routine treatment,the control group took atorvastatin,20 mg/times,1 times/d,and the observation group took rosuvastatin,10 mg/times and 1 times/d for 6 months. The changes of triglyceride( TG),total cholesterol( TC),high density lipoprotein( HDLC) and low density lipoprotein cholesterol( LDL-C) were detected in 2 groups of CHD patients. The hypersensitive C reactive protein( hs-CRP) and brachial artery blood flow mediated diastolic function( FMD) were observed,and the adverse reactions of the 2 groups were statistically analyzed. Results: The 2 groups completed the treatment according to the doctor's advice,without withdrawal or falling off. After treatment,the blood lipid index TG,TC and LDL-C in the observation group were significantly lower than those in the control group and the control group( P <0.05). The serum hs-CRP in the observation group decreased significantly after treatment,and the FMD increased significantly( P <0.05) after treatment. The 2 groups were all stable and only a small amount of minor adverse symptoms appeared. The adverse reaction rate of the observation group was 8.89%( 8/90),which was lower than that of the control group 11.11%( 10/90),but the difference between the 2 groups was not statistically significant( P >0.05). Conclusion: Atorvastatin and rosuvastatin are both safe and effective drugs for the treatment of elderly CHD,but rosuvastatin has better effects on lipid regulation,inhibition of inflammatory reaction and improvement of vascular endothelial function.
引文
[1]王健.短期强化阿托伐他汀治疗对冠心病患者血清脂肪相关因子、血管内皮功能障碍及心衰发生率的影响[J].湖南师范大学学报(医学版),2017,14(6):145~148.
[2] Jiang Q,Jiayi W U,Guo Y,et al.Detection of circulating microRNA levels and vascular endothelial function indicators in patients with coronary heart disease complicated with diabetes mellitus[J]. Journal of Fujian Medical University,2017,51(3):170~174.
[3] Dale C E,Fatemifar G,Palmer T M,et al.Causal associations of adiposity and body fat distribution with coronary heart disease,stroke subtypes and type 2 diabetes mellitus:a mendelian randomization analysis.[J].Circulation,2017,135(24):2373.
[4] Shek A B,Kurbanov R D,Abdullaeva G J,et al.P767Efficacy and safety of switching simvastatin intolerant patients with coronary artery disease to rosuvastatin treatment[J]. European Heart Journal,2017,38(1):256~257.
[5] Beyer A M,Zinkevich N,Miller B,et al. Transition in the mechanism of flow-mediated dilation with aging and development of coronary artery disease.[J]. Basic Research in Cardiology,2017,112(1):5.
[6]王鹏,严妍,于文君,等.阿托伐他汀与瑞舒伐他汀对冠心病患者的疗效与安全性对比观察[J].中国医院药学杂志,2018,38(2):169~172.
[7] Tzani A,Doulamis I,Konstantopoulos P,et al.Proteomics discovery of biomarkers in statin-treated patients with advanced coronary artery disease.[J]. Atherosclerosis,2017,26(3):e241.
[8] Shen W,Li J,Niu S,et al.Effects of atorvastatin on the changes of the levels of plasma soluble ICAM-1 and soluble VCAM-1 in patients with coronary heart disease[J].Clinical Medicine,2017,13(1):142~144.
[9] Lee Y H,Viji M,Lee E,et al.Synthesis and characterization of rosuvastatin calcium impurity A; a HMG-Co A reductase inhibitor[J]. Tetrahedron Letters,2017,58(26):2614~2617.
[10]黄涛,曾恋,田井强,等.瑞舒伐他汀治疗老年冠心病合并高脂血症的机制研究[J].重庆医学,2016,45(20):2801~2803.
[2] Jiang Q,Jiayi W U,Guo Y,et al.Detection of circulating microRNA levels and vascular endothelial function indicators in patients with coronary heart disease complicated with diabetes mellitus[J]. Journal of Fujian Medical University,2017,51(3):170~174.
[3] Dale C E,Fatemifar G,Palmer T M,et al.Causal associations of adiposity and body fat distribution with coronary heart disease,stroke subtypes and type 2 diabetes mellitus:a mendelian randomization analysis.[J].Circulation,2017,135(24):2373.
[4] Shek A B,Kurbanov R D,Abdullaeva G J,et al.P767Efficacy and safety of switching simvastatin intolerant patients with coronary artery disease to rosuvastatin treatment[J]. European Heart Journal,2017,38(1):256~257.
[5] Beyer A M,Zinkevich N,Miller B,et al. Transition in the mechanism of flow-mediated dilation with aging and development of coronary artery disease.[J]. Basic Research in Cardiology,2017,112(1):5.
[6]王鹏,严妍,于文君,等.阿托伐他汀与瑞舒伐他汀对冠心病患者的疗效与安全性对比观察[J].中国医院药学杂志,2018,38(2):169~172.
[7] Tzani A,Doulamis I,Konstantopoulos P,et al.Proteomics discovery of biomarkers in statin-treated patients with advanced coronary artery disease.[J]. Atherosclerosis,2017,26(3):e241.
[8] Shen W,Li J,Niu S,et al.Effects of atorvastatin on the changes of the levels of plasma soluble ICAM-1 and soluble VCAM-1 in patients with coronary heart disease[J].Clinical Medicine,2017,13(1):142~144.
[9] Lee Y H,Viji M,Lee E,et al.Synthesis and characterization of rosuvastatin calcium impurity A; a HMG-Co A reductase inhibitor[J]. Tetrahedron Letters,2017,58(26):2614~2617.
[10]黄涛,曾恋,田井强,等.瑞舒伐他汀治疗老年冠心病合并高脂血症的机制研究[J].重庆医学,2016,45(20):2801~2803.