摘要
目的:本研究旨在评价阿托伐他汀降VLDL-C的作用效果,并进一步探讨不同人群特征对于阿托伐他汀降VLDL-C疗效的影响。方法:本研究通过在北京市安贞医院门诊收集566名冠心病或脑卒中患者,给予20mg/d的阿托伐他汀治疗,共持续4周,在入选时进行问卷调查和体格检查,并同时检测治疗前后各血脂水平。结果:小剂量20mg/d阿托伐他汀治疗4周后,Non-HDL-C的达标率高达88.3%,VLDL-C的达标率为62.9%,远远高于LDL-C的20.1%的达标率(P<0.001)。多因素分析提示:影响VLDL-C达标率的因素主要包括性别(OR=2.16,95%CI:1.29~3.61,P=0.003),基线VLDL-C的水平(OR=1.249,95%CI:1.224~1.863,P<0.001)及TG水平(OR=2.282,95%CI:1.247~4.176,P=0.007)。结论:在阿托伐他汀降脂治疗中,VLDL-C较LDL-C更易达标;根据个体间的不同特点,采取针对性的治疗措施,以使患者达到更好的降脂效果。
Objective：To evaluate the efficacy of atorvastatin on VLDL-C among patients with the risk of CHD in China, and further explore the influence factors of the efficacy. Methods： 566 patients with the risk of CHD were recruited from anzhen hospital in China and were taken atorvastatin at a dose of 20mg/day for 4 weeks. A standard questionnaire and physical examination were measured at baseline. Venous blood samples were collected after an overnight fast at baseline and the end of 4-week atorvastatin therapy. Results： The re- suits showed significant responses of VLDL-C reducing to 4-week atorvastatin treatment among 566 patients. The VLDL-C levels decreased by 35.4% and the rate of VLDL-C goal achievement was 62. 9%, which was sig- nificantly higher than low density lipoprotein cholesterol （LDL-C） （20. 1%, P 〈0. 001 ）. Multivariable analy- sis showed females were less likely to achieve VLDL-C goals than males（ OR = 2. 16,95% CI： 1.29 - 3.61 ,P = 0. 003 ）. While the target rate of VLDL-C declined with the increased baseline levels of VLDL-C and TG （ OR = 1.25, 2. 82, respectively）. Conclnsion：Atorvastatin had a better lipid-lowering effect on reducing VLDL-C than LDL-C. VLDL-C would be a better predictor to evaluate the lipid-lowering effects and the risk of future CHD events for patients. Different characteristics might be exploited by doctors in clinical practice to provide a personalized medicine approach for individual patients.
出处
《心肺血管病杂志》
2017年第5期327-330,共4页
Journal of Cardiovascular and Pulmonary Diseases
基金
北京市医院管理局"登峰"计划专项经费(DFL20150601)
北京市医院管理局临床医学发展专项经费(ZYLX201303)
关键词
阿托伐他汀
极低密度脂蛋白胆固醇
达标率
Atorvastatin
Very low density lipoprotein cholesterol
Target rate
