冠状动脉搭桥术后患者应用中等剂量瑞舒伐他汀和辛伐他汀的疗效及安全性比较被引量：9

Comparison of efficacies and safeties between moderate dose of rosuvastatin and simvastatin in patients after coronary artery bypass grafting

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摘要目的:评价和比较中国患者在接受冠状动脉搭桥术(CABG)后应用中等剂量瑞舒伐他汀和辛伐他汀的有效性和安全性,以提供合理的CABG术后二级预防策略。方法:纳入本院符合研究标准的行CABG的患者。根据术后应用他汀类药物的种类分为瑞舒伐他汀组和辛伐他汀组,各150例。收集患者基线资料。记录2组患者入院时和术后1年时血脂状况。收集术后心血管死亡、再发心绞痛等主要不良心血管事件(MACE)和肝功能异常、肌病等安全性相关不良事件的发生情况,以及术后1年时复查冠状动脉CT血管造影(CTA)结果,并计算狭窄指数。结果:共完成随访286例,随访率95.3%,其中瑞舒伐他汀组完成随访140例,辛伐他汀组完成随访146例。血脂方面,与术前比较,瑞舒伐他汀组和辛伐他汀组患者术后1年时总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平均明显降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平明显升高(P<0.05)。MACE和安全性方面,2组组间比较差异无统计学意义(P>0.05)。桥血管狭窄情况,瑞舒伐他汀组和辛伐他汀组患者狭窄指数分别为4.55 (0~11.86)和5.78 (0~13.00),差异无统计学意义(P>0.05)。结论论:中等剂量瑞舒伐他汀和辛伐他汀均能使血清LDL-C水平达到降脂标准;2种药物的有效性和安全性无差异,均可用于中国冠心病患者CABG术后的二级预防策略。 Objective:To evaluate and compare the efficacies and safeties of moderate dose of rosuvastatin and simvastatin in the Chinese patients underwent coronary artery bypass grafting(CABG),and to provide a reasonable strategy for secondary prevention after CABG.Methods:The patients underwent CABG who met the study criteria in our hospital were included.According to the types of postoperatively administered statin drugs,the patients were divided into rosuvastatin group and simvastatin group,and there were 150 cases in each group.The baseline characteristics of patients and theirs blood lipid status at admission and 1 year after CABG were recorded.The occurrence of major adverse cardiovascular events(MACE)such as cardiovascular death and recurrent angina,as well as safety-related adverse events such as abnormal liver function and myopathy were noted.Meanwhile coronary computed tomography angiography(CTA)was performed 1 year after operation,and its stenosis index was calculated.Results:A total of 286 cases were followed up,with a follow-up rate of 95.3%,including 140 cases in rosuvastatin group and 146 cases in simvastatin group.In terms of blood lipid changes,compared with before operation,the total cholestrol(TC)and low density lipoprotein-cholesterol(LDL-C)levels in rosuvastatin grouop and simvastatin group 1 year after operation were significantly decreased(P<0.05),and the levels of high density lipoprotein-cholesterol(HDL-C)were significantly increased(P<0.05).In terms of MACE and safety events,there were no statistically significant differences between two groups(P>0.05).The stenosis indexes of the patients in rosuvastatin group and simvastatin group were 4.55(0—11.86)vs 5.78(0—13.00),and the difference was not statistically significant(P>0.05).Conclusion:Moderate dose of rosuvastatin and simvastatin can make the serum LDL-C level meet the standard of lipid lowering.There is no difference in the efficacies or safeties between two kinds of drugs,and both drugs could be used as secondary prevention strategies after CABG in the Chinese patients with coronary heart disease.

作者赵晨宇罗晓康段亚冰鞠帆孙寒松 ZHAO Chenyu;LUO Xiaokang;DUAN Yabing;JYU Fan;SUN Hansong(Department of Cardiovascular Surgery,Fuwai Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)

机构地区中国医学科学院北京协和医学院阜外医院心血管外科

出处《吉林大学学报（医学版）》 CAS CSCD 北大核心 2021年第2期477-482,共6页 Journal of Jilin University：Medicine Edition

基金北京市科学技术委员会自然科学基金面上项目(7162161) 北京协和医学院2019年研究生创新基金项目(2019-1002-49)。

关键词冠状动脉搭桥术瑞舒伐他汀辛伐他汀二级预防 coronary artery bypass grafting rosuvastatin simvastatin secondary prevention

分类号 R654.2 [医药卫生—外科学]

作者简介赵晨宇(1991-),男,辽宁省辽阳市人,在读博士研究生,主要从事冠心病外科治疗与预后改善方面的研究。;通信作者:孙寒松,教授,主任医师,博士研究生导师(E-mail:drsunhs@sina.com)。

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