吡格列酮联合瑞舒伐他汀钙对2型糖尿病患者高密度脂蛋白的干预效应  

The Protective Effect of Pioglitazone and Rosuvastatin Therapeutic Alliance on High Density Lipoprotein in Type 2 Diabetes Mellitus

作　　者：陈晓凤[1] 司艳红[2] 吕小红[3] 于爱玲[3] 董蓉蓉[1] 薛雅卓[1] 秦树存[1,2] 

机构地区：[1]泰山医学院护理学院,山东泰安271000 [2]泰山医学院动脉粥样硬化研究所,山东省高校动脉粥样硬化重点实验室,山东泰安271000 [3]泰安市中心医院,山东泰安271000

出　　处：《中国生物化学与分子生物学报》2016年第4期452-458,共7页Chinese Journal of Biochemistry and Molecular Biology

基　　金：国家自然科学基金(No.81170785,No.81391234);山东省泰山学者专项基金(200867)基金资助~~

摘　　要：动脉粥样硬化性心血管疾病是糖尿病最常见的并发症,而患者高密度脂蛋白(high density lipoprotein,HDL)水平和功能是影响AS发生发展的重要指标之一。本文旨在探讨吡格列酮与瑞舒伐他汀钙联合治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)患者HDL的改善作用,以期在临床上预测该治疗措施对糖尿病并发症的防治效果。将70例T2DM患者,按年龄、性别、病情、药物基本匹配的原则,分为对照组和吡格列酮组,每组35人,两组患者除常规使用胰岛素降糖治疗外,对照组给予瑞舒伐他汀钙片,吡格列酮组给予瑞舒伐他汀钙片及盐酸吡格列酮片,治疗3个月后临床观察患者空腹血糖(fasting blood sugar,FPG)、餐后血糖(post-prandial glycaemia,PPG)、糖化血红蛋白(glycated hemoglobin,Hb A1c)、甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)水平,同时提取患者HDL,检测不同药物治疗对HDL功能的改善效果。与治疗前相比,吡格列酮组患者FPG、PPG、Hb A1c、TC、TG及LDL-C均明显下降,HDLC水平明显升高;治疗后组间比较显示:与对照组相比,吡格列酮干预后患者HDL-C水平升高10.67%。HDL功能检测显示:药物治疗3月后,与对照组相比,吡格列酮组患者HDL介导细胞胆固醇外排效率增加25%,并使细胞内相关转运蛋白ATP结合盒转运体A1(ATP-binding cassette transporter A1,ABCA1)表达增加;同时,吡格列酮组患者HDL抗巨噬细胞凋亡功能亦明显提高。在2型糖尿病治疗中,吡格列酮联合瑞舒伐他汀钙不仅可以稳定血糖、血脂水平,而且可以升高HDL水平,改善HDL的功能,对于延缓T2DM患者出现心血管并发症具有重要意义。Atherosclerotic cardiovascular disease is the most common complication of diabetes mellitus（ DM）. The level and function of HDL is one of important indicators which has impact on the occurrence and development of atherosclerosis（ AS）. This study is conducted to determine the protective influence of pioglitazone and rosuvastatin therapeutic alliance on HDL of Type 2 DM（ T2DM） so as to clinically predict preventive effect of the treatment on DM complication. This study was carried out on 70 patients with T2 DM who were randomly divided into two groups,namely,control group and pioglitazone group.All patients in two groups were routinely injected with insulin. In addition,patients in control group took rosuvastatin and patients in pioglitazone group took rosuvastatin in combination with pioglitazone. After three months, fasting blood sugar（ FPG）, post-prandial glycaemia（ PPG）,glycated hemoglobin（ Hb A1c）,triglycerides（ TG）,total cholesterol（ TC）,low density lipoprotein-cholesterol（ LDL-C） and high density lipoprotein-cholesterol（ HDL-C） of patients in two groups were tested. Meanwhile,HDL was isolated to observe the protective effect of different drug treatment on HDL function. After treatment,FPG,PPG,Hb A1 c,TC,TG and LDL-C of patients in pioglitazone group were significantly decreased and HDL-C level was significantly increased. Group comparison indicated that pioglitazone intervention resulted in the promotion of HDL-C by 10. 67%. HDL functional test showed that compared with control group,the efflux efficiency of cells cholesterol mediated by HDL of patients in pioglitazone group was increased by 25% and HDL elevated the cells expression of related transporter ATP-binding cassette transporter A1（ ABCA1）. Moreover,the anti-apoptotic function of HDL in pioglitazone group was obviously improved. Pioglitazone and rosuvastatin therapeutic alliance not only makes blood glucose and lipid level steady,but also increases HDL level and function,which of great significance to dela

关 键 词：2型糖尿病 吡格列酮 瑞舒伐他汀钙 高密度脂蛋白 

分 类 号：R453[医药卫生—治疗学] R587[医药卫生—临床医学]