阿托伐他汀对老年2型糖尿病患者颈动脉内膜-中层厚度及血管内皮功能的影响  

Effect of atorvastatin on intima-media thickness patients with type 2 diabetes mellitus

作　　者：赵锦[1] 

机构地区：[1]深圳市宝安区人民医院内科,518101

出　　处：《中国医师进修杂志》2013年第13期16-21,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨不同剂量阿托伐他汀对老年2型糖尿病患者颈动脉内膜．中层厚度（IMT）及血管内皮功能的影响。方法选择172例老年2型糖尿病患者，按随机数字表法分为A组（阿托伐他汀10mg／d）63例、B组（阿托伐他汀20mg／d）54例及C组（阿托伐他汀40mg／d）55例，疗程为12个月。测定治疗前及治疗6、12个月血脂、高敏c反应蛋白（hs．CRP）、颈动脉IMT及血管内皮功能。结果三组治疗前血脂、hs．CRP、颈动脉硬化情况及血管内皮功能比较差异无统计学意义（P〉0．05）。三组治疗6、12个月总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇及hs．CRP明显降低，高密度脂蛋白胆固醇显著增高，差异有统计学意义（P〈0．05）。C组治疗12个月TC、TG及hs．CRP明显低于A组和B组[（3．52±0．55）mmol／L比（4．45±0．71）、（4．31±0．75）mmol／L，（1．20±0．12）mmol／L比（1．64±0．18）、（1．51±0．17）mmol／L，（4．22±0．28）mg／L比（5．34±0．48）、（5．02±0．44）mg／L]，差异有统计学意义（P〈0．05）。C组治疗12个月颈动脉IMT、斑块Crouse积分及斑块检出率与治疗前比较明显下降[（0．84±0．07）mm比（1．07±0．10）mm、（4．03±1．14）分比（4．34±1．18）分、41．8％（23／55）比78．2％（43／55）1，差异有统计学意义（P〈0．05）。C组治疗12个月内皮素及血栓素B2与治疗前比较明显降低[（68．48±9．35）-s／L比（90．07±10．19）ng／L，（80．08±14．27）nsm比（104．77±12．36）．g／L]，一氧化氮及6．酮．前列腺素F。。与治疗前比较明显增高[（72．28±9．40）斗mol／LtL（61．88±10．01）¨mol／L，（72．39±8．67）ndL比（54．92±10．78）ng门L]，差异有统计学意义（P〈0．05）。三组治疗12个月血流介导的内皮依赖性血管舒张功能明显改善（P〈0．05），B、C组治疗12个月硝酸甘油介导的非Objective To investigate the effects of various dose of atorvastatin on intima-media thickness （IMT） of carotid and endothelial function in elderly patients with type 2 diabetes mellitus（T2DM）. Methods One hundred and seventy-two elderly patients with T2DM were divided into three groups by random digits table method. Group A （63 cases） was treated with atorvastatin 10 mg/d,while group B （54 cases） was treated with atorvastatin 20 mg/d and group C （55 cases） was treated with atorvastatin 40 mg/d for 12 months. The serum levels of lipid,high-sensitive C reactive protein （hs-CRP）, IMT of carotid and endothelial function were measured before and after treatment of 6, 12 months. Results There were no significant differences in the levels of lipid, hs-CRP, IMT of carotid and endothelial function among three groups （P 〉0.05）. The levels of total cholesterol （TC）, triacylglycerol （TG）, low density lipoprotein cholesterol and hs-CRP were decreased and high density lipoprotein cholesterol was increased after treatment of 6,12 months in three groups （P 〈 0.05）. Tile levels of TC, TG and hs-CRP after treatment of 12 months in group C were lower than those in group A and group B [ （3.52 ~ 0.55） mmol/L vs. （4.45 ± 0.71 ）, （4.31 ~ 0.75） mmol/L, （1.20 ±0.12） mmol/L vs. （1.64 ±0.18）, （1.51 ±0.17） mmol/L, （4.22 ±0.28） mg/L vs. （5.34 ~ 0.48 ）, （5.02 ~ 0.44） mg/L], and there were significant differences （P 〈 0.05 ）. IMT of carotid, Crouse scores of plaque and the incidence of carotid plaque after treatment of 12 months in group C were lower than those before treatment [（0.84 ±0.07） mm vs. （1.07±0.10） mm, （4.03 ± 1.14） scores vs. （4.34 ± 1.18 ） scores, 41.8%（23/55 ） vs. 78.2%（43/55 ） ], and there were significant differences （P 〈 0.05 ）. The levels of endothelin and thromboxane B2 were markedly decreased in group C after treatment of 12 months [（68.48±9.35） ng/L vs. （90.07 ± 10.19） ng/L, （80.08 ± 1

关 键 词：糖尿病 2型 颈动脉 动脉粥样硬化 内皮功能 阿托伐他汀 

分 类 号：R587.1[医药卫生—内分泌]