目的 探討不同劑量瑞舒伐他汀治療老年冠心病合并高脂血癥的臨床療效.方法 選取2011年7月—2013年12月來都江堰市中醫(yī)醫(yī)院就診的老年冠心病合并高脂血癥患者240例,隨機分為辛伐他汀組,瑞舒伐他汀大、中、小劑量組,每組60例.辛伐他汀組患者晚餐后口服辛伐他汀片,20 mg/次,1次/d.瑞舒伐他汀大、中、小劑量組患者分別口服瑞舒伐他汀鈣片20、10、5 mg/次,1次/d.兩組均連續(xù)治療6個月.觀察各組的臨床療效,同時比較4組治療前后總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL)、低密度脂蛋白膽固醇(LDL)、頸動脈斑塊的面積、頸內(nèi)膜–中膜的厚度.結(jié)果 治療后,辛伐他汀組和瑞舒伐他汀大、中、小劑量組總有效率分別為63.33%、91.67%、76.67%、68.33%,大、中、小劑量組患者的總有效率明顯高于辛伐他汀組;大劑量組的總有效率明顯高于中、小劑量組,差異有統(tǒng)計學意義(P< 0.05).治療后,4組患者TG、TC、LDL、頸動脈斑塊面積和頸內(nèi)膜–中膜厚度均顯著降低,HDL顯著升高,同組治療前后差異有統(tǒng)計學意義(P< 0.05);且大、中劑量組的改善程度優(yōu)于辛伐他汀組,大劑量組的改善程度優(yōu)于中、小劑量組,差異有統(tǒng)計學意義(P< 0.05).結(jié)論 瑞舒伐他汀治療老年冠心病合并高脂血癥患者具有較好的療效,可有效改善患者的血脂水平,尤其是大劑量組療效更佳.

Objective To observe the clinical efficacy of different dosages of rosuvastatin in treatment of elderly coronary heart disease complicated with hyperlipidemia. Methods The patients with elderly coronary heart disease complicated with hyperlipidemia (240 cases) of the Hospital of Traditional Chinese Medicine in Dujiangyan City from July 2011 to December 2013 were randomly divided into simvastatin, large, medium, and small dosage groups, and each group had 60 cases. The patients in the simvastatin group were po administered with Simvastatin Tablets, 20 mg/time, once daily. The patients in rosuvastatin large, medium and small dosages groups were po administered with Rosuvastatin Calcium Tablets 20, 10, and 5 mg/time, once daily. Four groups were continuously treated for six months. After treatment, the clinical efficacy in four groups were evaluated, while the changes of TC, TG, HDL, LDL, area of carotid plaques, and thickness of vascular intima – membrane were compared. Results After treatment, efficacies in the simvastatin group, large, medium, and small dosage groups were 63.33%, 91.67%, 76.67%, and 68.33%. The efficacies in large, medium dosage groups were obviously higher than that in simvastatin group, while efficacies in large dosage group were obviously higher than those in medium and small dosage groups, and the difference was statistically significant (P <0.05). After treatment, TC, TG, LDL, area of carotid plaques, and thickness of vascular intima – membrane significantly reduced, and HDL significantly elevated, and the differences were statistically significant before and after treatment in the same group (P <0.05). The improvement degree of large and medium dosage groups were better than those in the simvastatin group, while improvement degree of large dosage group were better than thaose in the medium and small dosages groups, and the difference was statistically significant (P <0.05). Conclusion Rosuvastatin has a good clinical efficacy in treatment of elderly coronary heart disease complicated with hyperlipidemia, and can effectively improve the level of blood lipid, especially the curative effect of large dosage group is better.