冯翔, 姜睿, 潘世伟, 许建屏. 两种剂量匹伐他汀强化降脂对冠状动脉旁路移植术后早期代谢、安全性及预后影响的比较[J]. 心脏杂志, 2020, 32(2): 124-127. DOI: 10.12125/j.chj.201912047
    引用本文: 冯翔, 姜睿, 潘世伟, 许建屏. 两种剂量匹伐他汀强化降脂对冠状动脉旁路移植术后早期代谢、安全性及预后影响的比较[J]. 心脏杂志, 2020, 32(2): 124-127. DOI: 10.12125/j.chj.201912047
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    Xiang FENG, Rui JIANG, Shi-wei PAN, Jian-ping XU. Impact of intensive lipid-lowering therapy of pitavastatin on metabolism, safety and prognosis in patients early after CABG[J]. Chinese Heart Journal, 2020, 32(2): 124-127. DOI: 10.12125/j.chj.201912047
    Citation: Xiang FENG, Rui JIANG, Shi-wei PAN, Jian-ping XU. Impact of intensive lipid-lowering therapy of pitavastatin on metabolism, safety and prognosis in patients early after CABG[J]. Chinese Heart Journal, 2020, 32(2): 124-127. DOI: 10.12125/j.chj.201912047
    shu

    两种剂量匹伐他汀强化降脂对冠状动脉旁路移植术后早期代谢、安全性及预后影响的比较

    Impact of intensive lipid-lowering therapy of pitavastatin on metabolism, safety and prognosis in patients early after CABG

      摘要
    • 摘要:
        目的  对比大剂量即4 mg和常规剂量即2 mg匹伐他汀对冠状动脉旁路移植术(CABG)后早期代谢、安全性及预后的研究。
        方法  以单中心非盲随机对照的方式对152位受试者开展为期6个月的临床研究。
        结果  术后1周时，两组的丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）及肌酸激酶(CK)较基线水平均有所升高，但组间差异未达到显著水平；术后6个月时两组的ALT、AST、CK、肌酐（SCr）及非糖尿病患者的空腹血糖（FPG）较基线水平无明显变化，组间亦无明显差别；术后6个月时，两组的总胆固醇（TC）和低密度脂蛋白胆固醇(LDL-C)较基线水平均明显降低（P<0.05），且4 mg组较2 mg组降低更明显；4 mg组患者LDL-C下降超过50%的患者比例明显高于2 mg组(P<0.05)；两组患者的高密度脂蛋白胆固醇（HDL-C）较基线水平有所升高（P<0.05），但组间无明显差异；两组的甘油三酯（TG）较基线水平有所降低，但无统计学差异。术后6个月时两组主要心血管事件（MACE）发生率无明显差异。
        结论  与常规剂量的匹伐他汀相比，大剂量匹伐他汀能够更明显的降低LDL-C水平，术后早期两组MACE发生率尚无明显差异。

       

      Abstract:
        AIM   To evaluate the matabolism, safety and prognosis of the pitavastatin (4 mg VS 2 mg) in patients after coronary artery bypass graft (CABG).
        METHODS   An open-blind randomized control trial was conducted in a single cardiac center including 152 CABG patients for 6 months.
        RESULTS   ALT, AST and CK levels were increased at 1st week after CABG compared with baseline in both groups and there were no differences between groups. ALT, AST, CK, SCr and nondiabetic FPG levels were comparable with that of baseline levels at 6th month after CABG in both groups. TC and LDL-C levels at 6th month after CABG were decreased significantly compared with that at baseline in the both groups (P < 0.05) with the 4 mg group lower than the 2 mg group (P < 0.05). There were more patients in the 4 mg group than the 2 mg group in whom the statin reduced LDL-C more than 50%. HDL-C levels were increased at 6th month compared with baseline (P < 0.05), but there were no differences between the two groups. TG levels at 6th month after CABG were similar with baseline in both groups. The incidence rate of major adverse cardiovascular events (MACE) was similar between the two groups at 6 months.
        CONCLUSION   High dose of pitavastatin (4 mg) is more effective than low dose (2 mg) in decreasing LDL-C and equally safe with regards to increases in ALT, AST, CK, SCr and FPG levels early after CABG. The dosage of pitavastatin does not impact the incidence of MACE.

       

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