目的 探讨不同剂量瑞舒伐他汀治疗老年冠心病合并高脂血症的临床疗效.方法 选取2011年7月—2013年12月来都江堰市中医医院就诊的老年冠心病合并高脂血症患者240例,随机分为辛伐他汀组,瑞舒伐他汀大、中、小剂量组,每组60例.辛伐他汀组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、小剂量组患者分别口服瑞舒伐他汀钙片20、10、5 mg/次,1次/d.两组均连续治疗6个月.观察各组的临床疗效,同时比较4组治疗前后总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、颈动脉斑块的面积、颈内膜–中膜的厚度.结果 治疗后,辛伐他汀组和瑞舒伐他汀大、中、小剂量组总有效率分别为63.33%、91.67%、76.67%、68.33%,大、中、小剂量组患者的总有效率明显高于辛伐他汀组;大剂量组的总有效率明显高于中、小剂量组,差异有统计学意义(P< 0.05).治疗后,4组患者TG、TC、LDL、颈动脉斑块面积和颈内膜–中膜厚度均显著降低,HDL显著升高,同组治疗前后差异有统计学意义(P< 0.05);且大、中剂量组的改善程度优于辛伐他汀组,大剂量组的改善程度优于中、小剂量组,差异有统计学意义(P< 0.05).结论 瑞舒伐他汀治疗老年冠心病合并高脂血症患者具有较好的疗效,可有效改善患者的血脂水平,尤其是大剂量组疗效更佳.

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.