CAJ | 학술논문

目的：评价不同剂量阿托伐他汀对老年冠状动脉粥样硬化性心脏病（冠心病）合并高脂血症患者的临床疗效和安全性。方法选择2011年5月至2013年12月在深圳市福田区第二人民医院就诊的老年冠心病合并高脂血症患者120例，采用抛硬币法随机分为低剂量组和高剂量组，各60例。低剂量组给予阿托伐他汀每日20 mg，高剂量组每日给予40 mg，均晚饭后30 min服用，连续服用8周为1个疗程。比较两组的临床疗效，治疗期间心血管事件发生情况及治疗前后的血脂变化情况等。结果高剂量组总有效率为86.7％，低剂量组为70.0％，高剂量组治疗效果优于低剂量组（P＜0.01）。治疗8周后，两组患者总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL－C）水平均较治疗前显著下降（P＜0.01），高密度脂蛋白胆固醇（HDL－C）水平均较治疗前显著升高（P＜0.01）；治疗8周后，高剂量组TC、TG和HDL－C水平均较低剂量组显著升高，LDL－C水平较低剂量组显著下降（P＜0.01）。治疗期间高剂量组患者心血管事件发生率显著低于低剂量组（P＜0.05）。两组患者治疗过程中均未观察到明显的不良反应发生，所有患者均能坚持完成疗程。结论高剂量阿托伐他汀治疗老年冠心病合并高脂血症效果明显，安全性高，具有较高的临床价值。
목적：평개불동제량아탁벌타정대노년관상동맥죽양경화성심장병（관심병）합병고지혈증환자적림상료효화안전성。방법선택2011년5월지2013년12월재심수시복전구제이인민의원취진적노년관심병합병고지혈증환자120례，채용포경폐법수궤분위저제량조화고제량조，각60례。저제량조급여아탁벌타정매일20 mg，고제량조매일급여40 mg，균만반후30 min복용，련속복용8주위1개료정。비교량조적림상료효，치료기간심혈관사건발생정황급치료전후적혈지변화정황등。결과고제량조총유효솔위86.7％，저제량조위70.0％，고제량조치료효과우우저제량조（P＜0.01）。치료8주후，량조환자총담고순（TC）、삼선감유（TG）、저밀도지단백담고순（LDL－C）수평균교치료전현저하강（P＜0.01），고밀도지단백담고순（HDL－C）수평균교치료전현저승고（P＜0.01）；치료8주후，고제량조TC、TG화HDL－C수평균교저제량조현저승고，LDL－C수평교저제량조현저하강（P＜0.01）。치료기간고제량조환자심혈관사건발생솔현저저우저제량조（P＜0.05）。량조환자치료과정중균미관찰도명현적불량반응발생，소유환자균능견지완성료정。결론고제량아탁벌타정치료노년관심병합병고지혈증효과명현，안전성고，구유교고적림상개치。
Objective To evaluate the clinical efficacy and safety of different doses of atorvastatin on elderly patients with coronary heart disease combined with hyperlipidemia .Methods A total of 120 elderly patients with coronary heart disease and hyperlipidemia were in Shenzhen Futian Second People′s Hospital from May 2011 to Dec.2013 were included in the study,and they were randomly divided into low dose group and high dose group by coin toss method,60 cases in each group.Low dose group were given atorvastatin 20 mg daily,high dosage group was given 40 mg daily,both taken 30 minutes after dinner,8 consecutive weeks as one course.The clinical efficacy,the incidence of cardiovascular events during treatment,and blood lipid changes etc of the two groups were compared.Results The total effective rate of the high dose group was 86.7%,of the low dose group was 70.0%, the difference was statistically significant(P<0.01).The levels of total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) of both groups after 8 weeks of treatment were significantly decreased than before treatment , the differences were sta-tistically significant (P <0.01),high density lipoprotein cholesterol (HDL-C) levels was significantly increased after the treatment(P<0.01).After 8 weeks of treatment,levels of TC,TG and HDL-C in th high dose group were significantly higher than the low dose group ,while LDL-C level was significantly lower than the low dose group,the differences were statistically significant(P<0.01).During the treatment,the cardio-vascular events rate in the high dose group were significantly lower than the low dose group , the difference was statistically significant(P<0.05).There were no obvious adverse reaction observed in both group,and all patients completed the treatment.Conclusion High dose atorvastatin in the treatment of elderly patients with coronary heart disease and hyperlipidemia has obvious effect,with high safety,thus has a high clinical value.