不同剂量瑞舒伐他汀钙对老年冠心病伴高脂血症患者血清超敏C反应蛋白及颈动脉内膜中层厚度的影响

发布时间：2018-04-30 17:30

本文选题：瑞舒伐他汀钙 + 冠心病　；参考：《中国老年学杂志》2016年08期

【摘要】：目的探讨不同剂量瑞舒伐他汀钙对老年冠心病(CHD)伴高脂血症患者血脂、血清超敏C反应蛋白(hs-CRP)以及颈动脉内膜中层厚度(IMT)的影响。方法选择2011年1月至2015年3月因CHD伴高脂血症入院接受治疗的270例老年患者,随机均衡分为三组各90例,均采用降血糖、降血压、硝酸酯类药物及抗凝等常规治疗方式,对照组口服瑞舒伐他汀钙,5 mg/次,1次/d,观察1组在对照组基础上将瑞舒伐他汀钙剂量增为10 mg/次,观察2组在对照组基础上将瑞舒伐他汀钙剂量增为20 mg/次,疗程均为8 w。采用彩色多普勒超声仪观察三组治疗前后IMT变化情况,对比组间以及治疗前后血脂、hs-CRP水平变化。结果治疗前,三组患者hs-CRP水平无统计学差别(P0.05),治疗后hs-CRP水平均降低(P0.05),观察2组hs-CRP水平降低程度最大(P0.05);治疗前甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平无统计学差异(P0.05),治疗后均显著下降(P0.05),观察2组降低程度最大(P0.05);治疗前组间IMT值无统计学差异(P0.05),治疗后,三组患者IMT值较治疗前均下降(P0.05),观察2组IMT值降低程度最大(P0.05)。三组治疗后均无不良反应。结论 CHD伴高脂血症的老年患者服用瑞舒伐他汀钙后,IMT增厚现象、血脂升高情况显著改善,且疗效与药物剂量存在量效关系,同时发现hs-CRP与瑞舒伐他汀钙存在密切关系,因此分析IMT的改善与患者机体内hs-CRP间存在联系。
[Abstract]:Objective to investigate the effects of different doses of rosuvastatin calcium on blood lipids, serum hypersensitive C-reactive protein hs-CRP and carotid intima-media thickness (IMT) in elderly patients with coronary heart disease (CHD) and hyperlipidemia. Methods from January 2011 to March 2015, 270 elderly patients who were admitted to hospital for CHD with hyperlipidemia were randomly divided into three groups: 90 patients in each group. All patients were treated with hypoglycemia, hypotension, nitrate ester and anticoagulant. In the control group, the dosage of rosuvastatin calcium was increased to 10 mg/ on the basis of the control group, and the dosage of rosuvastatin calcium was increased to 20 mg/ on the basis of the control group. The course of treatment was 8 weeks. Color Doppler ultrasound was used to observe the changes of IMT before and after treatment, and to compare the changes of serum lipids and hs-CRP between groups and before and after treatment. Results before treatment, There was no significant difference in hs-CRP levels among the three groups (P 0.05), but the levels of hs-CRP were all decreased after treatment. The hs-CRP levels in the two groups were observed to be the largest (P 0.05), and the levels of triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were observed before treatment. There was no significant difference in the level of HDL-C between the two groups (P 0.05), but all of them were significantly decreased after treatment (P 0.05). The maximum degree of reduction was observed in the two groups (P 0.05), and there was no significant difference in IMT between the two groups before and after treatment (P 0.05), and after treatment, there was no significant difference between the two groups (P 0.05). The IMT value of the three groups was lower than that of before treatment (P 0.05). The maximum decrease of IMT was observed in the two groups (P 0.05). There were no adverse reactions after treatment in all three groups. Conclusion CHD with hyperlipidemia in the elderly patients with rosuvastatin calcium, the phenomenon of hyperlipidemia, serum lipids increased significantly improved, and the efficacy and dose-effect relationship with the drug, and found that there is a close relationship between hs-CRP and rosuvastatin calcium. Therefore, the relationship between the improvement of IMT and hs-CRP in patients was analyzed.
【作者单位】：江汉大学附属医院武汉市第六医院心血管内科;
【分类号】：R541.4;R589.2

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