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目的观察国产阿托伐他汀强化降脂治疗冠心病高危患者的疗效和安全性。方法将2004年9月至2005年6月河北医科大学第一医院心内科临床确诊为冠心病高危患者104名,随机分为两组:阿托伐他汀组10 mg/d 50例;阿托伐他汀40 mg/d 组54例。分别于用药前,用药1个月、3个月、6个月时测定血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、血糖(GLU)、肝肾功能和肌酸激酶(CK),共治疗6个月。结果 (1)治疗6个月后,与治疗前相比,阿托伐他汀10 mg/d 组 LDL-C、TC、TG 水平分别降低38.04%、29.37%、20.74%,HDL 水平升高了5.98%。40 mg/d 组 LDL-C、TC、TG 水平分别降低49.14%、37.69%、26.98%,HDL 水平升高3.48%。10 mg/d 组LDL-C 的达标率为54.00%,40 mg/d 组 LDL-C 的达标率为79.24%。两组间 LDL-C 的达标率差异有显著性(P<0.01)。(2)两组间治疗前后肝肾功能和肌酸激酶等未见明显差异。结论口服阿托伐他汀40 mg/d 较10mg/d 治疗能更有效的降低 LDL-C、TC 和 TG 水平,使 LDL-C 水平达标率高,且安全性一致。
Objective To observe the efficacy and safety of domestic atorvastatin on lipid-lowering therapy in patients with high-risk coronary heart disease. Methods From September 2004 to June 2005, the first clinical hospital of Hebei Medical University, Department of Cardiology clinically diagnosed as coronary heart disease in 104 high-risk patients were randomly divided into two groups: atorvastatin group 10 mg / d 50 cases; atorvastatin Statin 40 mg / d group of 54 cases. The levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), blood glucose (GLU), liver and kidney function and creatine kinase (CK) for a total of 6 months. Results (1) LDL-C, TC and TG levels in atorvastatin 10 mg / d group decreased by 38.04%, 29.37% and 20.74% respectively after 6 months treatment, and HDL levels increased by 5.98 %. The levels of LDL-C, TC and TG in 40 mg / d group decreased by 49.14%, 37.69% and 26.98%, respectively, and the level of HDL increased by 3.48%. The compliance rate of LDL-C in 10 mg / d group was 54.00%, and the compliance rate of LDL-C in 40 mg / d group was 79.24%. There was a significant difference in the compliance rate of LDL-C between the two groups (P <0.01). (2) There was no significant difference between the two groups before and after treatment of liver and kidney function and creatine kinase. Conclusions Oral atorvastatin 40 mg / d is more effective than 10 mg / d in lowering LDL-C, TC and TG levels and achieving high LDL-C compliance and safety.