中国临床药学杂志

目的 探究瑞舒伐他汀强化降脂方案对冠心病患者血脂及心率变异性的影响。方法 将医院于2021年6月至2023年6月收治的254例冠心病患者，按照随机数字表法分成强化组和常规组，各127例。常规组予瑞舒伐他汀10 mg,po,qd；强化组予瑞舒伐他汀20 mg,po,qd。比较2组治疗前后血脂指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]，心率变异性指标[NN间期均值标准差(SDANN)、NN间期标准差(SDNN)、相邻NN间期差值>50 ms的百分比(pNN50)]，以及血液流变学指标[血浆黏度、全血低切黏度和全血高切黏度]的变化情况以及不良反应，并评估2组临床疗效。结果 强化组患者治疗后总有效率高于常规组(χ²=4.890,P=0.027)；与治疗前相比，治疗后强化组和常规组的TG、TC、LDL-C水平，血浆黏度、全血低切黏度和全血高切黏度显著降低，HDL-C、SDANN、SDNN、pNN50水平均显著升高(P<0.05)；治疗后，与常规组相比，强化组的TG、TC、LDL-C水平，血浆黏度、全血低切黏度和全血高切黏度显著降低，HDL-C、SDANN、SDNN、pNN50水平显著升高(P<0.05)。2组不良反应发生率之间差异无统计学意义(P > 0.05)。结论 瑞舒伐他汀强化降脂方案治疗冠心病患者的疗效显著，可以调节患者的血脂水平，调节心率变异性，改善血流变指标，且安全性较好。

AIM To investigate the effect of rosuvastatin-intensive lipid-lowering therapy on plasma lipids and heart rate variability in patients with coronary heart disease.METHODS A total of 254 patients with coronary heart disease admitted to the hospital from June 2021 to June 2023 were selected and divided into conventional group and intensive group according to the random number table method,with 127 patients in each group.Patients in the conventional group (n=127) received rosuvastatin 10 mg,po,qd and patients in the intensive group (n=127) received rosuvastatin 20 mg,po,qd.The changes in blood lipid indexes[triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C)],heart rate variability indexes[mean standard deviation of normal R-R intervals (SDANN),standard deviation of normal R-R intervals (SDNN),percentage of adjacent R-R intervals differing by more than 50 ms (p NN50)],and hemorheological parameters (plasma viscosity,whole blood low-shear viscosity,and whole blood high-shear viscosity) before and after treatment,as well as the adverse reactions,were compared between the 2 groups.Moreover,the clinical efficacy of the 2 groups was evaluated.RESULTS The efficacy of the intensive group was higher than that of the conventional group (χ²=4.890,P=0.027).Compared with before treatment,the levels of TG,TC,LDL-C,plasma viscosity,whole blood low shear viscosity,and whole blood high shear viscosity in the intensive group and conventional group were reduced after treatment.In contrast,the levels of HDL-C,SDANN,SDNN,and p NN50 were increased (P<0.05).After treatment,compared with the conventional group,the levels of TG,TC,LDL-C,plasma viscosity,whole blood low shear viscosity,and whole blood high shear viscosity in the intensive group were reduced.In contrast,the levels of HDL-C,SDANN,SDNN,and p NN50 were increased (P<0.05).There was no difference in the incidence of adverse reactions between 2 groups (P>0.05).CONCLUSION Rosuvastatinintensive lipid-lowering therapy demonstrates significant clinical efficacy in coronary heart disease patients by regulating lipid profiles,modulating heart rate variability,and improving hemorheological parameters,with favorable safety outcomes.