目的 对比观察国产阿托伐他汀(阿乐)与进口阿托伐他汀(立普妥)对老年人颈动脉内膜中层厚度(IMT)及血脂水平的影响. 方法 将符合标准的108例患者随机分为2组,治疗组口服阿乐10 mg/d(n=57),对照组口服立普妥10 mg/d(n=51),疗程24周.观察治疗前、后颈动脉IMT及血脂变化,药物不良反应等.结果 2组药物治疗24周后与治疗前组内比较颈总动脉和双侧颈动脉分叉处IMT有明显改善(P＜0.01),颈内动脉IMT无明显改善(P＞0.05)；2组组间比较IMT则无统计学差异(P＞0.05).治疗24周后2组血脂低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)均明显下降,与治疗前相比有明显统计学差异(P＜0.01),2组间无明显差异(P＞0.05),不良反应发生率2组比较无明显差异(P＞0.05),2组均未发现严重肝肾功受损或肌酶升高. 结论 国产阿托伐他汀10 mg/d对改善我国老年人颈动脉IMT厚度、血脂LDL-C、TC水平与进口阿托伐他汀10 mg/d疗效等同,且不良反应小、价格低廉,可作为我国老年人调脂治疗的常规药物.%Objective To explore the effect of domestic atorvastatin and imported atorvastatin on carotid artery inti-ma-media thickness (IMT) and the levels of blood fat in elderly patients. Methods One hundred and eight patients were randomly divided into two groups:treatment group(n=57, receiving domestic atorvastatin therapy for 24 weeks, 10 mg/d) and control group(n = 51, receiving imported atorvastatin therapy for 24 weeks, 10 mg/d). During the next 24 weeks, the changes of carotid IMT and the levels of blood fat after treatment and the adverse reactions were observed. Results There was a significant improvement (P <0. 01) in the common carotid artery and its bifurcation IMT after treatment for 24 weeks, whereas there was no significant difference in the internal carotid artery IMT ( P > 0. 05 ). There was no statistical difference in IMT between the two groups ( P > 0. 05 ) . After treatment, the levels of LDL-C and TC were significantly decreased(P<01) , while there was no statistical difference between the two groups(P >0. 05). And the incidence rate of adverse events between the two groups also had no significant statistical difference ( P > 0. 05 ). No patients showed severe damage of liver function and the increase of creatase. Conclusions Treatment with domestic atorvastatin and imported atorvastatin (10 mg/d) have the same effect on IMT and the level of blood fat. Domestic atorvastatin has a good safety and a lower price,and should be the regular medicine for elderly patients.
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