中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
2期
208-210
,共3页
崔芳%魏庆民%刘翠华%张萌
崔芳%魏慶民%劉翠華%張萌
최방%위경민%류취화%장맹
血脂康%阿托伐他汀%不稳定型心绞痛%丙氨酸转氨酶
血脂康%阿託伐他汀%不穩定型心絞痛%丙氨痠轉氨酶
혈지강%아탁벌타정%불은정형심교통%병안산전안매
Xuezhikang Capsule%Atorvastatin%Unstable angina pectoris%Alanine aminotransferase
目的:探讨血脂康对不稳定型心绞痛伴肝酶升高患者的疗效与安全性。方法纳入96例服用阿托伐他汀后引起肝酶升高3倍以上的不稳定型心绞痛患者。随机均分为3组,每组32例患者,A组停阿托伐他汀;B组阿托伐他汀减半;C组更换为血脂康。总疗程为4周,治疗前后测定总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三脂(TG)、高敏C反应蛋白(hs-CRP)、丙氨酸转氨酶(ALT)。随访主要不良心血管事件(MACEs),包括心源性死亡、致死性心肌梗死(MI)、非致死性MI、猝死发生情况。结果与治疗前比较,治疗4周后三组患者ALT水平均显著下降,治疗前后比较有统计学差异(P<0.05),A、C组患者ALT水平下降较B组患者更显著,与B组患者比较有统计学差异(P<0.05),A、C组之间ALT水平比较,无统计学差异(P>0.05)。B、C组患者治疗4周后TC、LDL-C、TG、hs-CRP水平均下降,治疗前后比较有统计学差异(P<0.05);C组患者HDL-C水平较治疗前升高(P<0.05),治疗前后比较有统计学差异(P<0.05);A组患者TC、LDL-C、TG、hs-CRP水平下降不明显,治疗前后比较无统计学差异(P>0.05)。与A组患者治疗后比较,C组患者TG、hs-CRP水平明显下降,差异有统计学意义(P<0.05)。A组、B组、C组MACEs事件发生率分别为12.5%、9.4%、3.1%,组间比较差异有统计学意义(P<0.05)。结论他汀引起肝酶显著升高的不稳定型心绞痛患者,换用血脂康安全有效。本研究入选患者病例数较少,有待更多的试验证实。
目的:探討血脂康對不穩定型心絞痛伴肝酶升高患者的療效與安全性。方法納入96例服用阿託伐他汀後引起肝酶升高3倍以上的不穩定型心絞痛患者。隨機均分為3組,每組32例患者,A組停阿託伐他汀;B組阿託伐他汀減半;C組更換為血脂康。總療程為4週,治療前後測定總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、甘油三脂(TG)、高敏C反應蛋白(hs-CRP)、丙氨痠轉氨酶(ALT)。隨訪主要不良心血管事件(MACEs),包括心源性死亡、緻死性心肌梗死(MI)、非緻死性MI、猝死髮生情況。結果與治療前比較,治療4週後三組患者ALT水平均顯著下降,治療前後比較有統計學差異(P<0.05),A、C組患者ALT水平下降較B組患者更顯著,與B組患者比較有統計學差異(P<0.05),A、C組之間ALT水平比較,無統計學差異(P>0.05)。B、C組患者治療4週後TC、LDL-C、TG、hs-CRP水平均下降,治療前後比較有統計學差異(P<0.05);C組患者HDL-C水平較治療前升高(P<0.05),治療前後比較有統計學差異(P<0.05);A組患者TC、LDL-C、TG、hs-CRP水平下降不明顯,治療前後比較無統計學差異(P>0.05)。與A組患者治療後比較,C組患者TG、hs-CRP水平明顯下降,差異有統計學意義(P<0.05)。A組、B組、C組MACEs事件髮生率分彆為12.5%、9.4%、3.1%,組間比較差異有統計學意義(P<0.05)。結論他汀引起肝酶顯著升高的不穩定型心絞痛患者,換用血脂康安全有效。本研究入選患者病例數較少,有待更多的試驗證實。
목적:탐토혈지강대불은정형심교통반간매승고환자적료효여안전성。방법납입96례복용아탁벌타정후인기간매승고3배이상적불은정형심교통환자。수궤균분위3조,매조32례환자,A조정아탁벌타정;B조아탁벌타정감반;C조경환위혈지강。총료정위4주,치료전후측정총담고순(TC)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、감유삼지(TG)、고민C반응단백(hs-CRP)、병안산전안매(ALT)。수방주요불양심혈관사건(MACEs),포괄심원성사망、치사성심기경사(MI)、비치사성MI、졸사발생정황。결과여치료전비교,치료4주후삼조환자ALT수평균현저하강,치료전후비교유통계학차이(P<0.05),A、C조환자ALT수평하강교B조환자경현저,여B조환자비교유통계학차이(P<0.05),A、C조지간ALT수평비교,무통계학차이(P>0.05)。B、C조환자치료4주후TC、LDL-C、TG、hs-CRP수평균하강,치료전후비교유통계학차이(P<0.05);C조환자HDL-C수평교치료전승고(P<0.05),치료전후비교유통계학차이(P<0.05);A조환자TC、LDL-C、TG、hs-CRP수평하강불명현,치료전후비교무통계학차이(P>0.05)。여A조환자치료후비교,C조환자TG、hs-CRP수평명현하강,차이유통계학의의(P<0.05)。A조、B조、C조MACEs사건발생솔분별위12.5%、9.4%、3.1%,조간비교차이유통계학의의(P<0.05)。결론타정인기간매현저승고적불은정형심교통환자,환용혈지강안전유효。본연구입선환자병례수교소,유대경다적시험증실。
Objective To investigate the curative effect and safety of Xuezhikang Capsule in patients with unstable angina pectoris (UAP) complicating elevated liver enzymes. Methods The patients (n=96) with UAP and liver enzymes elevated by 3 times after taking atorvastatin were randomly divided into group A (stopping taking atorvastatin), group B (taking half-dose atorvastatin) and group C (taking Xuezhikang Capsule only, each n=32). The total therapeutic course was 4 w. The levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP) and alanine aminotransferase (ALT) were detected before and after treatment. The incidence of major adverse cardiac events (MACE) was followed up including cardiac death, fatal myocardial infarction (MI), non-fatal MI and sudden death. Results After treatment for 4 w, ALT level decreased significantly in 3 groups (P<0.05), which was more significant in group A and group C (P<0.05), but there was no statistical difference between group A and group C (P>0.05). After treatment for 4 w, the levels of TC, LDL-C, TG and hs-CRP decreased in group B and group C (P<0.05). The level of HDL-C increased in group C after treatment (P<0.05). The decreases of levels of TC, LDL-C, TG and hs-CRP were not significant (P>0.05) in group A after treatment. Compared with group A after treatment, the levels of TG and hs-CRP decreased significantly in group C (P<0.05). The incidence of MACE was 12.5%in group A, 9.4%in group B and 3.1%in group C (P<0.05). Conclusion In UAP patients with elevated liver enzymes induced by atorvastatin, Xuezhikang Capsule is safe and effective for them. Because of the study has less cases, further trials are needed to proof the results.