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目的比较阿托伐他汀与普伐他汀对老年冠心病合并糖尿病患者的疗效与安全性。方法选择2011年11月—2013年9月收治的107例冠心病合并糖尿病老年患者作为研究对象,随机分为A组54例和B组53例。在常规治疗的基础上,A组给予阿托伐他汀治疗,10 mg/次,口服,1次/d,B组给予普伐他汀治疗,10 mg/次,口服,1次/d;两组均治疗2个月。对比分析两组患者临床疗效与不良反应发生情况。监测患者FBG、TC、TG、LDL-C、HDLC、hs-CRP和apo-B水平。计量资料组间比较采用t检验,组内比较采用配对t检验,计量资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,A组的FBG、TC、TG、LDL-C、hs-CRP和apo-B水平[(5.97±0.52)、(3.02±0.41)、(1.29±0.17)、(2.01±0.81)mmol/L、(5.12±2.95)mg/L、(1.01±0.19)g/L]比治疗前[(9.58±0.72)、(5.52±0.77)、(2.36±0.51)、(3.62±0.71)mmol/L、(11.48±4.71)mg/L、(1.37±0.28)g/L]显著降低,差异均有统计学意义(均P<0.05)。B组的FBG、TC、LDL-C、hs-CRP和apo-B水平[(6.02±0.56)、(3.87±0.53)、(2.35±0.77)mmol/L、(6.97±4.12)mg/L、(1.08±0.31)g/L]比治疗前[(9.52±0.69)、(5.54±0.80)、(3.64±0.75)mmol/L、(11.45±4.80)mg/L、(1.38±0.25)g/L]显著降低,差异均有统计学意义(均P<0.05)。治疗后两组间TC、TG、LDL-C、hs-CRP和apo-B水平差异均有统计学意义(均P<0.05)。A组治疗总有效率为94.44%,明显高于B组的81.13%,差异有统计学意义(P<0.05)。结论与普伐他汀相比,阿托伐他汀在治疗老年冠心病合并糖尿病患者的疗效更显著,安全性高,值得临床推广使用。
Objective To compare the efficacy and safety of atorvastatin and pravastatin in elderly patients with coronary heart disease complicated with diabetes mellitus. Methods A total of 107 elderly patients with coronary heart disease and diabetes mellitus admitted from November 2011 to September 2013 were randomly divided into group A (n = 54) and group B (n = 53). On the basis of routine treatment, patients in group A were given atorvastatin 10 mg once daily, pravastatin in group B 10 mg once daily orally, Treatment for 2 months. Comparative analysis of two groups of patients with clinical efficacy and adverse reactions occurred. Patients were monitored for FBG, TC, TG, LDL-C, HDLC, hs-CRP and apo-B levels. Measurement data were compared between groups using t test, the group compared with paired t test, measurement data using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the levels of FBG, TC, TG, LDL-C, hs-CRP and apo-B in group A were significantly higher than those in group A (5.97 ± 0.52, 3.02 ± 0.41, 1.29 ± 0.17 and 2.01 ± 0.81, (5.12 ± 0.72), (5.52 ± 0.77), (2.36 ± 0.51), (3.62 ± 0.71) mmol / L, L, (11.48 ± 4.71) mg / L and (1.37 ± 0.28) g / L], respectively, with statistical significance (all P <0.05). The levels of FBG, TC, LDL-C, hs-CRP and apo-B in group B were significantly higher than those in group B (6.02 ± 0.56 vs 3.87 ± 0.53, 2.35 ± 0.77 mmol / L and 6.97 ± 4.12 mg / (1.08 ± 0.31) g / L] were significantly higher than those before treatment [(9.52 ± 0.69), (5.54 ± 0.80), (3.64 ± 0.75) mmol / L, (11.45 ± 4.80) mg / L] were significantly lower, the differences were statistically significant (P <0.05). After treatment, the differences of TC, TG, LDL-C, hs-CRP and apo-B between the two groups were statistically significant (all P <0.05). The total effective rate of group A was 94.44%, which was significantly higher than 81.13% of group B, the difference was statistically significant (P <0.05). Conclusions Compared with pravastatin, atorvastatin is more effective and effective in the treatment of elderly patients with coronary heart disease and diabetes mellitus, which is worthy of clinical promotion.