浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
16期
1398-1401
,共4页
阿托伐他汀%急性冠状动脉综合征%超敏C反应蛋白%同型半胱氨酸%老年
阿託伐他汀%急性冠狀動脈綜閤徵%超敏C反應蛋白%同型半胱氨痠%老年
아탁벌타정%급성관상동맥종합정%초민C반응단백%동형반광안산%노년
Atorvastatin%Acute coronary syndrome%High sensitivity C- reactive protein%Homocysteine%Elderly people
目的：比较不同剂量阿托伐他汀对老年急性冠状动脉综合征（ACS）患者超敏C反应蛋白（hs- CRP）、同型半胱氨酸（Hcy）水平的影响及安全性。方法选择老年ACS患者162例，分为A组（阿托伐他汀20mg/d）、B组（阿托伐他汀40mg/d）、C组（阿托伐他汀80mg/d），各54例，所有患者分别于入院后24 h内和服药后4周、12周采血测定hs- CRP、Hcy、TG、TC、HDL- C、LDL- C。入院后24 h内和服药后12周清晨空腹采静脉血，测定ALT、肌酸激酶（CK）、血肌酐（SCr）水平。结果3组患者治疗后TC、LDL- C、TG水平均较治疗前下降（P＜0.05或0.01），B、C组患者治疗后第12周HDL- C水平较治疗前升高（P＜0.05）。与A组比较，B组在治疗第4周时LDL- C水平降低，第12周时TC、LDL- C水平降低（P＜0.05），C组在治疗第4、12周时TC、LDL- C、TG水平均降低（P＜0.05或0.01），治疗第12周时HDL- C水平升高（P＜0.05）。治疗后3组患者hs- CRP、Hcy水平均较治疗前下降（P＜0.05或0.01），与A组比较，B、C组在治疗第4、12周时hs- CRP、Hcy水平均降低（P＜0.05或0.01）。治疗后3组患者ALT、CK、SCr水平均未见明显升高（均P＞0.05），与A组治疗后第12周比较，B、C组ALT、CK、SCr水平差异均无统计学意义（均P＞0.05）。结论在老年ACS患者中，80mg/d阿托伐他汀治疗是有效且安全的。
目的：比較不同劑量阿託伐他汀對老年急性冠狀動脈綜閤徵（ACS）患者超敏C反應蛋白（hs- CRP）、同型半胱氨痠（Hcy）水平的影響及安全性。方法選擇老年ACS患者162例，分為A組（阿託伐他汀20mg/d）、B組（阿託伐他汀40mg/d）、C組（阿託伐他汀80mg/d），各54例，所有患者分彆于入院後24 h內和服藥後4週、12週採血測定hs- CRP、Hcy、TG、TC、HDL- C、LDL- C。入院後24 h內和服藥後12週清晨空腹採靜脈血，測定ALT、肌痠激酶（CK）、血肌酐（SCr）水平。結果3組患者治療後TC、LDL- C、TG水平均較治療前下降（P＜0.05或0.01），B、C組患者治療後第12週HDL- C水平較治療前升高（P＜0.05）。與A組比較，B組在治療第4週時LDL- C水平降低，第12週時TC、LDL- C水平降低（P＜0.05），C組在治療第4、12週時TC、LDL- C、TG水平均降低（P＜0.05或0.01），治療第12週時HDL- C水平升高（P＜0.05）。治療後3組患者hs- CRP、Hcy水平均較治療前下降（P＜0.05或0.01），與A組比較，B、C組在治療第4、12週時hs- CRP、Hcy水平均降低（P＜0.05或0.01）。治療後3組患者ALT、CK、SCr水平均未見明顯升高（均P＞0.05），與A組治療後第12週比較，B、C組ALT、CK、SCr水平差異均無統計學意義（均P＞0.05）。結論在老年ACS患者中，80mg/d阿託伐他汀治療是有效且安全的。
목적：비교불동제량아탁벌타정대노년급성관상동맥종합정（ACS）환자초민C반응단백（hs- CRP）、동형반광안산（Hcy）수평적영향급안전성。방법선택노년ACS환자162례，분위A조（아탁벌타정20mg/d）、B조（아탁벌타정40mg/d）、C조（아탁벌타정80mg/d），각54례，소유환자분별우입원후24 h내화복약후4주、12주채혈측정hs- CRP、Hcy、TG、TC、HDL- C、LDL- C。입원후24 h내화복약후12주청신공복채정맥혈，측정ALT、기산격매（CK）、혈기항（SCr）수평。결과3조환자치료후TC、LDL- C、TG수평균교치료전하강（P＜0.05혹0.01），B、C조환자치료후제12주HDL- C수평교치료전승고（P＜0.05）。여A조비교，B조재치료제4주시LDL- C수평강저，제12주시TC、LDL- C수평강저（P＜0.05），C조재치료제4、12주시TC、LDL- C、TG수평균강저（P＜0.05혹0.01），치료제12주시HDL- C수평승고（P＜0.05）。치료후3조환자hs- CRP、Hcy수평균교치료전하강（P＜0.05혹0.01），여A조비교，B、C조재치료제4、12주시hs- CRP、Hcy수평균강저（P＜0.05혹0.01）。치료후3조환자ALT、CK、SCr수평균미견명현승고（균P＞0.05），여A조치료후제12주비교，B、C조ALT、CK、SCr수평차이균무통계학의의（균P＞0.05）。결론재노년ACS환자중，80mg/d아탁벌타정치료시유효차안전적。
Objective To assess the efficacy and safety of atorvastatin with different doses in elderly patients with acute coronary syndrome. Methods One hundred and sixty elderly patients with acute coronary syndrome were treated with atorvas-tatin of 20mg/d (group A, n=54), 40mg/d (group B, n=54) or 80mg/d (group C, n=54). Serum high sensitive C- reactive protein (hs- CRP), homocysteine(Hcy), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol(HDL- C), low density lipoprotein cholesterol(LDL- C) were measured before treatment and at week 4, 12 of treatment;and the alanine aminotransferase (ALT), creatinnine kinase (CK) and creatinine (Scr) levels were also measured before treatment and at week12 of treatment. Re-sults TC, LDL- C, TG levels after treatment in al 3 groups were lower than those before treatment (P<0.05 or 0.01). The HDL- C levels were higher at week12 of treatment than those before treatment in groups B and C (P<0.05). LDL- C level at week4 of treatment was lower in group B than that in group A (P<0.05);TC, LDL- C and TG levels at week4, 12 of treatment were lower in group C than those in group A (P<0.05 or 0.01). HDL- C at week12 of treatment in group C was higher than that in group A (P<0.05). The hs- CRP and Hcy levels in three groups were lower after treatment than those before treatment (P<0.05 or 0.01);hs- CRP and Hcy levels at week 4, 12 of treatment in groups B and C were lower than those in group A(P<0.05 or 0.01). ALT, CK, SCr levels were not significantly increased after treatment in al groups, and there were no significant differences in ALT, CK and SCr levels at week 12 of treatment among groups A, B and C (P>0.05). Conclusion Atorvastatin therapy at dose of 80mg/d is effective and safe for elderly patients with acute coronary syndrome.
