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4种他汀类药物治疗动脉粥样硬化的疗效和安全性比较
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| 篇名： | 4种他汀类药物治疗动脉粥样硬化的疗效和安全性比较 |
| TITLE： | |
| 摘要： | 目的：比较4种他汀类药物治疗动脉粥样硬化（AS）的疗效和安全性。方法：168例AS患者随机分为A组（42例）、B组（42例）、C组（42例）和D组（42例）。各组患者均给予低脂饮食+酒石酸美托洛尔片50 mg，口服+硝苯地平片5 mg，口服+拜阿司匹林肠溶片100 mg，口服，均为夜间睡前服用。在此基础上，A组患者给予阿托伐他汀钙片20 mg，口服；B组患者给予辛伐他汀片40 mg，口服；C组患者给予普伐他汀钠片20 mg，口服；D组患者给予瑞舒伐他汀钙片10 mg，口服，均为夜间睡前服用。各组疗程均为6个月。比较各组患者治疗前后总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、单核细胞趋化蛋白-1（MCP-1）、转化生长因子-β（TGF-β）、基质金属蛋白酶-9（MMP-9）水平，颈动脉内膜中层厚度（IMT）、斑块面积、斑块数目及不良反应发生情况。结果：治疗后TC、TG、LDL-C、MCP-1、TGF-β、MMP-9水平均显著低于同组治疗前，HDL-C水平均显著高于同组治疗前，且治疗3个月后TC、TG、LDL-C水平B组＜A组＜C、D组，HDL-C水平B组＞A组＞C、D组，MCP-1、TGF-β、MMP-9水平A、D组＜B、C组；治疗6个月后TC、TG、LDL-C水平B、C组＜A、D组，MCP-1水平A、D组＜B、C组，MMP-9、TGF-β水平A、D组＜C组＜B组，差异均有统计学意义（P＜0.05）。治疗6个月后，各组患者IMT、斑块数目、斑块面积均显著低于同组治疗前，且IMT A、D组＜B、C组，斑块数目A组＜D组＜B、C组，差异均有统计学意义（P＜0.05）。各组患者不良反应发生率比较差异均无统计学意义（P＞0.05）。结论：在常规治疗的基础上加用4种他汀类药物治疗AS均可显著降低血脂水平，但瑞舒伐他汀与阿托伐他汀在抗炎、维持斑块稳定方面作用更优，且4种药物安全性均较好。 |
| ABSTRACT： | OBJECTIVE： To compare the efficacy and safety of 4 kinds of statins in the treatment of peripheral atherosclerosis （AS）. METHODS： 168 AS patients were randomly divided into group A （42 cases）， group B （42 cases）， group C （42 cases） and group D （42 cases）. All patients were given low-fat diet + Metoprolol tartrate tablet 50 mg， orally+Nifedipine tablet 5 mg， orally+Aspirin enteric - coated tablet 100 mg， orally， taking in the evening before going to bed. Based on it， group A received Atorvastatin calcium tablet 20 mg， orally， taking in the evening before going to bed； group B received Atorvastatin tablet 20 mg， orally， taking in the evening before going to bed； group C received Pravastatin sodium tablet 20 mg， orally， taking in the evening before going to bed； group D received Rosuvastatin calcium tablet 10 mg， orally， taking in the evening before going to bed. All patients were treated for 6 mongths. TC， TG， LDL-C，HDL-C，MCP-1， TGF-β， MMP-9， IMT， plaque area， plaque number before and after treatment， and the incidence of adverse reactions in each group were compared. RESULTS： After treatment， TC， TG， LDL-C， MCP-1， TGF-β and MMP-9 in each group were significantly lower than before， HDL-C was significantly higher than before； after 3 months， the TC， TG and LDL-C in group B were lower than group A， which was lower than group C and group D， HDL-C in group B was higher than group A， which was higher than group C and group D， MCP-1， TGF-β and MMP-9 in group A and group D were lower than group B and group C； after 6 months， the TC， TG and LDL-C in group B and group C were lower than group A and group D， MCP-1 in group A and group D was lower than group B and group C， MMP-9 and TGF-β in group A and group D were lower than group C， which was lower than group B（P＜0.05）. After 6 months， IMT， plaque number and area in each group were significantly lower than before， IMT in group A and group D was lower than group B and group C， plaque number in group A was lower than group D， which was lower than group B and group C（P＜0.05）， so as the incidence of adverse reactions （P＞0.05）. CONCLUSIONS： Based on conventional treatment， 4 drugs of statins can effectively reduce the level of blood lipid，but rosuvastatin is better than atorvastatin in anti-inflammation and keep plaques stable， the 4 statins have good safety. |
| 期刊： | 2016年第27卷第36期 |
| 作者： | 黄海燕，鄢卫民 |
| AUTHORS： | HUANG Haiyan，YAN Weimin |
| 关键字： | 动脉粥样硬化；阿托伐他汀；辛伐他汀；普伐他汀；瑞舒伐他汀；疗效；安全性 |
| KEYWORDS： | Atherosclerosis； Atorvastatin； Simvastatin； Pravastatin； Rosuvastatin； Efficacy； Safety |
| 阅读数： | 451 次 |
| 本月下载数： | 5 次 |
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