老年患者应用不同类型他汀的疗效及安全性分析
Efficacy and safety comparison of different statins in elderly patients
陈亚红 1江成功 1刘梅林 1刘芳 1范琰1
作者信息
摘要
目的 观察老年患者应用阿托伐他汀、瑞舒伐他汀及血脂康的疗效与安全性.方法 回顾性分析2009年1月至2014年3月于北京大学第一医院就诊或住院的服用他汀类的老年患者314例,年龄60～94(73.6±7.9)岁.根据服用他汀种类分为3组:阿托伐他汀组108例,平均剂量(16.4 ±4.8)mg/d;瑞舒伐他汀组104例,平均剂量(8.7±3.0) mg/d;血脂康组102例,平均剂量(0.9 ±0.3)g/d.观察治疗前及治疗4周后的血脂水平、丙氨酸氨基转移酶(ALT)及肌酸激酶(CK)情况.依据2007年《中国成人血脂异常防治指南》推荐的心血管疾病危险分层方案,各组患者分为中危(3组分别为13、12和21例)、高危(3组分别为40、44和48例)和极高危(3组分别为55、48和33例),计算各组不同危险分层血脂达标率及达标剂量.结果 3组患者治疗4周后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(非HDL-C)水平与治疗前比较均明显下降(P均＜0.01).治疗前后LDL-C水平,阿托伐他汀组分别为(3.14±0.78)和(2.14±0.65) mmol/L,瑞舒伐他汀组分别为(2.92±0.77)和(1.96±0.55)mmol/L,血脂康组分别为(2.70±0.62)和(2.16 ±0.61)mmol/L,P均＜0.01.治疗后LDL-C达标率,阿托伐他汀组、瑞舒伐他汀组及血脂康组的中危患者分别为13/13、11/12和20/21,高危患者分别为95.0％ (38/40)、86.4％(38/44)和83.3％ (40/48),极高危患者分别为40.0％ (22/55)、62.5％ (30/48)和51.5％ (17/33).不同危险分层的3组患者LDL-C、非HDL-C及TC达标率差异均无统计学意义(P＞0.05).阿托伐他汀组1例患者ALT出现3倍以上升高,各组均无CK升高超过正常上限5倍者.结论 老年心血管病患者应用小剂量和(或)常规剂量的阿托伐他汀、瑞舒伐他汀及血脂康降脂治疗安全、有效.
Abstract
Objective To compare the efficacy and safety of atorvastatin,rosuvastatin and xuezhikang capsule in elderly.Methods A total of 314 60-to-94-year-old (average (73.6 ± 7.9) years old) patients who were given different doses and types of statins were divided into three groups:the atorvastatin group (108 patients),the rosuvastatin group (104 patients) and the xuezhikang capsule group (102 patients).The serum TG,TC,LDL-C,HDL-C,ALT and CK were examined before and after the treatment which lasted for at least 4 weeks.All patients were divided into moderate risk group (13,12 and 21 patients respectively in 3 groups) ; high risk group (40,44 and 48 patients respectively in 3 groups) and very high risk group (55,48 and 33 patients respectively in 3 groups) according to guidelines on prevention and treatment of dyslipidemia in chinese adults (2007 version).The rate of reaching target goal and the dose when reaching target levels in different risk stratification groups were calculated and compared.Results Serum TC,LDL-C and non-HDL-C were significantly reduced after the 4-week-treatment in all the three groups (P ＜ 0.01).Serum LDL-C level before and after treatment were (3.14 ± 0.78) mmol/L vs.(2.14 ±0.65) mmol/L in atorvastatin group (the arevage dose was (16.4 ± 4.8) mg/d),(2.92 ± 0.77)mmol/L vs.(1.96 ±0.55) mmol/L in rosuvastatin group (the arevage dose was (8.7 ±3.0) mg/d),and (2.70 ±0.62) mmol/L vs.(2.16 ±0.61) mmol/L in xuezhikang capsule group (the arevage dose was (0.9 ± 0.3) g/d).Among all the three groups of patients,the cases of reaching target levels of LDL-C were 13,11 and 20 in patients at moderate risk,were 38(95.0％),38(86.4％) and 40 (83.3％) in patients at high risk,and were 22(40.0％),30(62.5％) and 17(51.5％) in patients at very high risk.There were no statistical differences in the rate of reaching target levels of LDL-C,non-HDL-C and TC in the three groups and at different risks (P ＞ 0.05).One patient in the atorvastatin group showed ALT level elevation ＞ 3 times of the upper limit of normal value,there was no patient with CK level elevation ＞ 5 times of the upper limit of normal value.Conclusion Atorvastatin,rosuvastatin and xuezhikang capsule at low dose and/or standard dose are effective and safety in elderly patients.
关键词
降血脂药/降血脂药(中药)/老年人/治疗结果Key words
Antilipemic agents/Antilipemic agents(TCD)/Aged/Treatment outcome引用本文复制引用
基金项目
国家科技支撑计划(2012BAI37B00)
出版年
2014
NETL
NSTL
维普
万方数据