老年动脉粥样硬化性心血管疾病患者他汀类药物使用现状

目的探讨他汀类药物在老年动脉粥样硬化性心血管疾病(ASCVD)患者中的使用现状。方法筛选医院电子病历数据,选择2014年1月~2018年12月在解放军第九六〇医院和德州市第二人民医院收治的年龄≥60岁的ASCVD患者15751例,按患者的年龄分为60~69岁组6230例,70~79岁组5192例和≥80岁组4329例。调查3组患者他汀类药物使用现状,分析他汀类药物使用的影响因素,比较患者LDL-C、非HDL-C控制达标的情况。结果≥80岁组外周动脉粥样硬化疾病比例明显高于60~69岁组和70~79岁组(1.6%vs 1.1%和0.8%,P=0.000)。所有患者他汀类药物使用率为67.4%,急性冠状动脉综合征(ACS)患者他汀类药物使用率99.2%、PCI后为98.3%、冠状动脉旁路移植术(CABG)后为95.2%。多因素logistic回归分析显示,ACS、PCI后、CABG后、住院科室、入院时间是影响他汀类药物使用的独立危险因素(P<0.05,P<0.01)。与60~69岁组和70~79岁组比较,≥80岁组LDL-C达标率(48.07%vs 32.98%和30.97%)及非HDL-C达标率(38.99%vs 30.99%和28.76%)均明显升高(P<0.01)。结论他汀类药物在老年ASCVD急症患者中使用率较高,但在慢病管理中的使用及血脂达标情况仍有待提高。

Use of statins in elderly atherosclerotic cardiovascular disease patients

Objective To investigate the use of statins in elderly atherosclerotic cardiovascular disease(ASCVD)patients.Methods A total of 15751≥60 years old ASCVD patients admitted to Chinese PLA No.960 Hospital and Dezhou No.2 People’s Hospital from January 2014 to December 2018 were divided into 60-69 years group(n=6230),70-79 years group(n=5192)and≥80 years group(n=4329).The use of statins was investigated,the factors influencing the use of statins were analyzed,and the effective control of LDL-C and non-HDL-C was compared in 3 groups.Results The incidence of peripheral atherosclerosis was significantly higher in≥80 years group than in 60-69 years group and 70-79 years group(1.6%vs 1.1%,1.6%vs 0.8%,P=0.000).The utilization rate of statins was 67.4%,99.2%,98.3%and 95.2%respectively in ASCVD patients and patients with ACS、PCI、CABG.Analysis showed that ACS,hospitalized departments after PCI and CABG,admission time were the independent risk factors for the use of statins(P<0.05,P<0.01).The effective control rate of LDL-C and non-HDL-C was significantly higher in≥80 years group than in 60-69 years group and 70-79 years group(48.07%vs32.98%,48.07%vs 30.97%,P<0.01;38.99%vs 30.99%,38.99%vs 28.76%,P<0.01).Conclusion The utilization rate of statins is considerably high in ASCVD patients.The use of statins in chronic diseases management and effective control of LDL-C need to be improved.