| 熊绘,荣曾霞,冯健.不同品种他汀类药物治疗高脂血症伴冠心病对血脂达标率的影响[J].安徽医药,2026,30(11):2305-2310. |
| 不同品种他汀类药物治疗高脂血症伴冠心病对血脂达标率的影响 |
| Study on the effect of different varieties of statins on the lipid compliance rate in the treatment of hyperlipidemia with coronary heart disease |
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| DOI：10.3969/j.issn.1009-6469.2026.11.036 |
| 中文关键词: 胆固醇合成酶抑制剂 高脂血症 冠心病 瑞舒伐他汀 辛伐他汀 血脂达标率 影响因素 预测模型 |
| 英文关键词: Statin Hyperlipidemia Coronary heart disease Rosuvastatin Simvastatin Lipid compliance rate Influencing factors Predictive modeling |
| 基金项目:四川省医学科技创新研究会资助项目( YCH-KY-YCZD2024-058) |
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| 中文摘要: |
| 目的探究不同品种他汀类药物治疗高脂血症伴冠心病对血脂达标率的影响，并分析影响因素。方法前瞻性分析 2022年 4月至 2024年 4月在自贡市第三人民医院使用他汀类药物治疗高脂血症伴冠心病病人 190例，按随机数字表法分为观察组 95例与对照组 95例，对照组给予辛伐他汀治疗，观察组给予瑞舒伐他汀治疗，均治疗 3个月，比较两组治疗前后血脂指标水平、不良反应发生状况、血脂达标率的差异，通过二元 logistic回归模型分析血脂达标率影响因素，并构建预测模型。结果相较于治疗前，治疗 3个月后两组总胆固醇( TC)、三酰甘油( TG)、低密度脂蛋白胆固醇( LDL-C)均降低，高密度脂蛋白胆固醇(HDL-C)水平均升高( t观察组 =33.11、25.24、20.39、23.43；对照组 =14.88、11.58、7.21、17.15，P<0.05)且观察组治疗 3个月后血脂指标水平优于对照组( t=18.28、17.43、10.18、5.48，P<0.05)t。观察组不良反应总发生率( 10.54%)低，于对照组( 27.37%)(χ2=8.78， P<0.05)。观察组病人治疗后血脂达标 39例，达标率为 41.05%，对照组血脂达标 14例，达标率为 14.74%，观察组病人治疗后血脂达标率高于对照组( P<0.05)。二元 logistic回归模型分析显示，年龄、他汀类药物品种(瑞舒伐他汀)、糖尿病病史、高脂血症病程(10年)受教育程度(高中及以下)医疗费用支付方式(新农合 /自费)均是他汀类药物治疗高脂血症伴冠心病后血脂达标率的影响因素(、P<0.05)。受试者操作特征、曲线( ROC曲线)分析显示，年龄、他汀类药物品种、糖尿病病史、高脂血症病程、受教育程度、医疗费用支付方式预测他汀类药物治疗高脂血症伴冠心病后血脂达标率的曲线下面积( AUC)分别为 0.76、0.66、0.62、0.73、0.53、0.64；预测模型预测他汀类药物治疗高脂血症伴冠心病后血脂达标率的 AUC为 0.91，灵敏度为 0.94，特异度 0.75。结论瑞舒伐他汀治疗高脂血症伴冠心病可有效改善血脂水平，促进血脂达标，减少不良反应发生率；年龄、他汀类药物品种(瑞舒伐他汀)、糖尿病病史、高脂血症病程( 10年)、受教育程度(高中及以下)、医疗费用支付方式(新农合 /自费)均是他汀类药物治疗高脂血症伴冠心病后血脂达标率的影响因素，基于上述相关因素构建的预测模型预测血脂达标率准确性较高。 |
| 英文摘要: |
| Objective To investigate the effects of different varieties of statins in the treatment of hyperlipidemia with coronary heartdisease on the rate of lipid target attainment rate, and to analyze the influencing factors.Methods One hundred and ninety cases of pa-tients with hyperlipidemia with coronary heart disease treated with statins in Zigong Third People's Hospital from April 2022 to April2024 were prospectively analyzed, and divided into two groups according to the method of randomized numerical table, 95 cases in thestudy group and 95 cases in the control group, the control group was given simvastatin treatment, and the patients in the study groupwere given Rosuvastatin treatment, and both of them were treated for 3 months, the differences in the levels of lipid indexes, the occur-rence status of adverse reactions, and the lipid attainment rate were compared between the two groups before and after treatment. Theinfluencing factors of lipid target attainment rate were analyzed by binary logistic regression model, and a prediction model was con‐structed.Results Compared to pre-treatment, total cholesterol (TC), triacylglycerol (TG), and low-density lipoprotein cholesterol (LDL-C) were reduced in both groups after 3 months of treatment, and high-density lipoprotein cholesterol (HDL-C) levels were increased in both groups (t study group = 33.11, 25.24, 20.39, 23.43; t control group = 14.88, 11.58, 7.21, 17.15, P<0.05), and the level of lipid indexes in the study group was better than that in the control group after 3 months of treatment (t=18.28, 17.43, 10.18, 5.48, P<0.05). The total inci-dence of adverse reactions in the study group (10.54%) was lower than that in the control group (27.37%) (χ2=8.77, P<0.05). The pa-tients in the study group reached the standard of blood lipids after treatment in 39 cases, with a rate of 41.05%, and the control groupreached the standard of blood lipids in 14 cases, with a rate of 14.74%, which was higher than that of the control group (P<0.05). Binarylogistic regression model analysis showed that age, statin type (Rosuvastatin), history of diabetes, duration of hyperlipidemia (10 years),education (high school and below), and mode of payment of medical expenses (new rural cooperative medical scheme/self-funded) were factors influencing the rate of lipid attainment after statin treatment of hyperlipidaemia with coronary artery disease (all P<0.05). Analy-sis of the subjects' work characteristic curves (ROC curves) showed that the area under the curve (AUC) for age, statin variety, historyof diabetes, duration of hyperlipidaemia, literacy, and healthcare payment method to predict the lipid attainment rate after statin treat-ment of hyperlipidaemia with coronary heart disease were 0.76, 0.66, 0.62, 0.73, 0.53, and 0.64, respectively. The model data predictedan AUC of 0.91, sensitivity of 0.94, and specificity of 0.75 for lipid attainment rate after statin treatment of hyperlipidaemia with coro-nary heart disease.Conclusions Rosuvastatin treatment of hyperlipidemia with coronary heart disease can effectively improve bloodlipid levels, facilitate lipid attainment, and reduce the incidence of adverse reactions; age, statin variety (Rosuvastatin), history of diabe-tes mellitus, duration of hyperlipidemia (10 years), education (high school and below), and mode of payment of medical expenses (newrural cooperative medical scheme/self-funded) are the factors affecting the rate of lipid attainment rate after statin treatment of hyperlip-idemia with coronary heart disease. The prediction model constructed on the basis of the above factors has high accuracy in predictinglipid attainment. |
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