【摘要】 目的 :探讨不同辛伐他汀剂量的调脂疗效、安全性和预防心脏性事件的作用。方法 :将 115例高脂血症随机单盲分为 2组 :10 m g组 5 7例 ,辛伐他汀 10 m g/ d;2 0 m g组 5 8例 ,辛伐他汀 2 0 m g/ d,均观察 1年 ,观察调脂效果、不良反应及心脏性事件发生情况。结果 :2 0 mg组治疗后总胆固醇 ( TC)、甘油三酯 ( TG)、 L DL - C、载脂蛋白 ( Apo) B均明显下降 ( P<0 .0 1) ,HDL- C、Apo A1 均显著升高 ( P<0 .0 5 ,P<0 .0 1) ,疗效明显优于 10 mg组。调脂总达标率 ,TC、 L DL - C达标率 2 0 mg组示较 10 mg组高 ( P<0 .0 1)。随访 1年显示 :2 0 mg组治疗后对不稳定型心绞痛 ( NSAP)、非致命性心肌梗死、心力衰竭、经皮腔内冠状动脉成形术 /冠状动脉旁路术 ( PTCA/ CABG)、心脏性病死率、总病死率发生危险性均有下降趋势 ,但组间比较差异无显著性 ( P>0 .0 5 )。发生 NSAP的危险性下降 ,( P<0 .0 5 ) ,两组不良反应均轻微。结论 :应用辛伐他汀 2 0 mg/ d治疗高脂血症、预防心脏性事件较 10 mg/ d更适合。更多还原

【Abstract】 Objective: To investigate the efficacy and safety of two different doses of simvastatin in the treatment of dyslipidemia,and their effects on preventing cardiac events Methods: 115 cases of dyslipidemia were randomly assigned into two groups,the former(group A,57 cases)given simvastatin 10 mg nightly,while the latter(group B,58 cases)20 mg nightly Patients of both groups were observed for one year. Results: Total cholesterol(TC),triglycerin(TG),low density lipoprotein cholesterol(LDL C),apoprotein B were decreased ( P <0 01),while high density lipoprotein cholesterol(HDL C),apoprotein A 1 increased( P <0 05, P <0 01)after the therapy in both groups The amplitudes changed of these items were larger in group B than in group A( P <0 01) Percentage of patients that reached target TC and LDL C were higher in group B than in group A( P <0 01) The incidences of attack by unstable angina pectoris,nonfatal myocardiol infarction,heart failure, percutaneous transluminal angioplasty(PTCA)/coronary artery bypass grafting(CABG) in group B were lower than in group A after one year( P <0 05) Adverse reactions were mild and similar in both groups There was no patient being admitted in hospital,suffering from permanent disability,neoplasm due to taking simvastatin Conclusion: Simvastatin 20 mg/d is more suitable in treating dyslipidemia and preventing cardiac events,and is of a good tolerability profile更多还原