阿托伐他汀对老年2型糖尿病患者颈动脉硬化的影响  

Effect of atorvastatin on carotid atherosclerosis in elderly patients with type 2 diabetes mellitus

作　　者：郭远[1] 孙立新[1] 李卫[1] 李飞颖[1] 张学武[1] 

机构地区：[1]北京大学人民医院,北京100044

出　　处：《中华老年心脑血管病杂志》2008年第10期757-759,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨阿托伐他汀对老年2型糖尿病患者颈动脉硬化的影响。方法选择100例合并颈动脉硬化的老年2型糖尿病患者,随机分为对照组50例(仅控制血糖)和联合组50例(在控制血糖基础上,口服阿托伐他汀20mg/晚),疗程为12个月。测定治疗前后颈动脉硬化相关指标、血脂及高敏C反应蛋白(hs-CRP)。结果两组患者治疗前颈动脉内膜中层厚度(IMT)、斑块检出率、斑块Crouse积分及颈动脉内径无显著差异;与治疗前比较,对照组治疗12个月后颈动脉IMT、斑块检出率及Crouse积分明显增加(P<0.05),颈动脉内径、血脂及hs-CRP水平无明显变化;联合组治疗12个月后颈动脉IMT、斑块检出率、Crouse积分明显降低,颈动脉内径明显增加(P<0.05),治疗6个月、12个月后血清LDL-C、TG、TC、hs-CRP明显降低,HDL-C明显升高(P<0.05)。IMT、Crouse积分均与LDL-C、TG、TC、hs-CRP呈正相关,与HDL-C呈负相关(P<0.05)。结论在控制血糖的同时,联合应用阿托伐他汀,对延缓老年2型糖尿病患者颈动脉硬化进展有一定影响。Objective To investigate the effects of atorvastatin on carotid atherosclerosis in elderly patients with type 2 diabetes mellitus （T2DM）. Methods One hundred elderly patients with T2DM and carotid atherosclerosis were randomly divided into two groups. Control group was treated with hypoglycemic drugs alone; while combination group was treated with both atorvastatin（20 mg/d） and hypoglycemic drugs. The carotid atherosclerosis parameter and the serum levels of lipid and high-sensitive C reactive protein（hs-CRP） were measured before and after treat- ment for 12 months. Results Carotid intima-media thickness（IMT）, the incidence of carotid plaque and Crouse scores of plaque decreased in the combination group and increased in the control group after treatment for 12 months （P〈0.05）. The internal diameter of carotid increased in combination group （P〈0.05）and did not change significantly in control group during same time. The serum levels of LDL-C,TG,TC and hs-CRP were reduced and the serum level of HDL-C was increased significantly 6 months after treatment in the combination group （P〈0.05）and did not change in control group. Moreover, both IMT and Crouse scores were positively correlated with the serum levels of LDL-C, TG, TC, and hs-CRP, negatively correlated with the serum level of HDL-C. Conclusions Combined with hypoglycemic treatment, atorvastatin can delay the progress of carotid atherosclerosis and stabilize plaques in elderly T2DM patients.

关 键 词：糖尿病 非胰岛素依赖型 颈动脉疾病 降血脂药 降血糖药 阿托伐他汀 

分 类 号：R587.1[医药卫生—内分泌]