他汀类药物对糖尿病合并动脉粥样硬化性心血管疾病患者的治疗效果  

Therapeutic effect of statins on patients with diabetes mellitus complicated atherosclerotic cardiovascular diseases

作　　者：林德洪[1] 陈漠水[1] 杜子君[1] 李强[1] 

机构地区：[1]海口市人民医院心内科,海南海口570208

出　　处：《心血管康复医学杂志》2017年第4期413-416,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨他汀类药物对2型糖尿病(T2DM)合并动脉粥样硬化性心血管疾病患者的治疗效果。方法:回顾性分析2013年10月至2015年12月在我院就诊的T2DM合并动脉粥样硬化性心血管疾病患者103例的临床资料。根据是否使用他汀类药物,患者被分为常规治疗组(50例,不使用他汀类药物)和他汀组(53例,在常规治疗基础上加用他汀类药物),两组均治疗1年。测量比较两组治疗前后血脂水平,以及治疗期间的心脑血管事件发生情况。结果:与治疗前比较,他汀组治疗后甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白-胆固醇(LDLC)水平显著降低,高密度脂蛋白-胆固醇(HDL-C)水平显著升高(P均<0.01)。与常规治疗组比较,他汀组治疗后TG[(2.13±0.37)mmol/L比(1.74±0.41)mmol/L]、TC[(5.38±0.45)mmol/L比(4.34±0.73)mmol/L]和LDL-C[(3.63±0.72)mmol/L比(2.55±0.61)mmol/L]水平降低更显著,HDL-C水平[(0.95±0.31)mmol/L比(1.34±0.35)mmol/L]升高更显著,P均<0.01。治疗1年期间,他汀组心脑血管事件发生率显著低于常规治疗组(18.18%比56.67%),P=0.002。结论:他汀类药物能够有效纠正2型糖尿病合并动脉粥样硬化性心血管疾病患者的脂质代谢异常,降低心脑血管事件的发生风险。Objective： To explore therapeutic effect of statins on patients with type 2 diabetes mellitus （T2DM） complicated atherosclerotic cardiovascular diseases. Methods： Clinical data of 103 T2DM patients with atherosclerotic cardiovascular diseases, who were treated in our hospital from Oct 2013 to Dec 2015, were retrospectively studied. According to usage of statins or not, patients were divided into routine treatment group （n = 50, didn＇t use statins） and statin group （n = 53, received statins based on routine treatment）, both groups were treated for one year. Blood lipid levels before and after treatment, and incidence of cardio- and cerebrovascular events during treatment were measured and compared between two groups. Results： Compared with before treatment, after treatment, there were significant reductions in levels of triglyceride （TG）, total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C）, and significant rise in level of high density lipoprotein cholesterol （HDL-C） in statin group （P〈0. 01 all）. Compared with routine treatment group after treatment, there were significant reductions in levels of TG [（2.13±0.37） mmol/Lvs. （1.74±0.41） mmol/L3, TCE （5.38±0.45） mmol/Lvs. （4.34±0.73） mmol/L] and LDL-C[（3.63±0.72） mmol/L vs. （2.55±0.61） mmol/L3, and significant rise in HDL-C level [（0.95±0.31） mmol/L vs. （1.34±0.35） mmol/L] in statin group, P〈0.01 all. During one-year treatment, incidence rate of cardio-and cerebrovascular events in statin group was significantly lower than that of routine treatment group （18.18% vs. 56.67%）, P = 0. 002. Conclusion： Statins could effectively correct abnormal lipid metabolism and reduce risk of cardio- and cerebrovascular events in patients with type 2 diabetes mellitus complicated atherosclerosis cardiovascular diseases.

关 键 词：糖尿病 2型 冠心病 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病]