不同劑量阿托伐他汀治療冠心病臨床療效觀察

[摘要] 目的 觀察不同劑量阿托伐他汀治療冠心病的臨床療效性和安全性。 方法 133例冠心病患者隨機分為高劑量組和低劑量組，分別接受阿托伐他汀40 mg/d和20 mg/d，療程6個月。觀察兩組血脂改變和不良反應情況。 結果 兩組患者治療后血清TC、TG和LDL-C水平明顯降低，HDL-C明顯增高，與治療前比較差異均具有統計學意義（P<0.05）；但高劑量組改變更為顯著。兩組在1個月時的不良反應發生率比較差異有統計學意義（P<0.05），在3、6個月時的差異均無統計學意義（P>0.05）。 結論 阿托伐他汀40 mg/d可以明顯減少心絞痛發作，降低血脂，安全性和阿托伐他汀20 mg/d基本類似。

[關鍵詞] 阿托伐他汀；冠心病；心絞痛；高脂血癥；動脈硬化

[中圖分類號] R541.4 [文獻標識碼] B [文章編號] 2095-0616（2012）22-57-02

Clinical observation of different doses of atorvastatin in the treatment of coronary heart disease

MI Yanqi

Department of Pharmacy，People's Hospital of Weifang City， Weifang 261041，China

[Abstract] Objective To observe the clinical effects and safety of different doses of atorvastatin in the treatment of coronary heart disease. Methods 133 patients with coronary artery disease were randomly divided into the high-dose group and low-dose group， were treated with atorvastatin in 40 mg/d and 20 mg/d for 6 months. The changes of blood lipid and the occurrence of adverse reactions in two groups were observed. Results After treatment， serum TC， TG and LDL-C levels were significantly decreased in two groups of patients， HDL-C was increased significantly， the differences were statistically significant（P<0.05）.But more significant changes in the high-dose group. The incidence of adverse reactions in 1 month of the two groups had a significant difference（P<0.05）， but in 3 and 6 months，the differences were not statistically significant（P>0.05）. Conclusion Atorvastatin in the dose of 40 mg/d can significantly reduce the attack of angina pectoris and the level of blood lipid，the medication safety is similar to the dose of 20 mg/d.

[Key words] Atorvastatin； Coronary heart disease；Angina pectoris；Hyperlipidemia； Arteriosclerosis

冠心病即冠狀動脈硬化性心臟病，主要是指脂質代謝異常，多余的脂質在光滑的動脈內膜上沉積，發生動脈粥樣硬化，使動脈腔變窄，血流受阻，心肌缺血而發生心絞痛。阿托伐他汀適用于混合性高脂血癥，而其非降脂作用在冠心病的防治作用中也發揮著重要作用。筆者采用兩種不同劑量阿托伐他汀治療冠心病，并對療效進行比較，報道如下。

1 資料與方法

1.1 一般資料

本組患者共133例，為筆者所在醫院2009年1月～2011年6月心內科診治的冠心病患者，均通過心電圖、心肌酶檢查、心臟超聲和冠狀動脈造影等確診，診斷符合WHO診斷標準。血脂異常診斷標準：總膽固醇（TC）≥4.68 mmol/L，或（和）低密度脂蛋白（LDL-C）≥3.60 mmol/L。同時排除嚴重感染、糖尿病、惡性腫瘤、肝腎功能不全、對所用藥物過敏的患者。133例……