大剂量阿托伐他汀对糖尿病合并不稳定型心绞痛患者经皮冠状动脉介入术后血脂及炎症的影响  

Effect of high-dose atorvastatin on blood lipids and inflammation in patients with diabetes mellitus complicated with unstable angina pectoris after PCI

作　　者：孙为鹏[1] 史凤磊[2] 朱淑珍 周震[5] 孙慧 Sun Weipeng;Shi Fenglei;Zhu Shuzhen;Zhou Zhen;Sun Hui(Department of Pharmacy,Qingdao Municipal Hospital,Qingdao 266000,China)

机构地区：[1]山东青岛市市立医院药剂科,青岛266000 [2]山东青岛市市立医院中医科,青岛266000 [3]山东青岛市市立医院检验科,青岛266000 [4]山东大学齐鲁医院检验医学中心 [5]青岛大学附属医院查体中心

出　　处：《中国临床保健杂志》2020年第1期84-88,共5页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨大剂量阿托伐他汀对糖尿病合并不稳定型心绞痛患者经皮冠状动脉介入术(PCI)治疗后血脂、炎症的影响。方法采用随机数字法将166例经冠状动脉造影(GAG)确诊为糖尿病合并不稳定型心绞痛且PCI治疗后的患者分为两组,每组83例。两组均给予常规药物治疗,对照组常规药物治疗的基础上给予剂量为20 mg/d阿托伐他汀,观察组加至40 mg/d。比较两组治疗前后血脂[三酰甘油(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]、炎症[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)及肿瘤坏死因子α(TNF-α)]、血管内皮相关指标[血管内皮生长因子(VEGF)、外周血循环内皮细胞(CEC)及内皮祖细胞(EPCs)]及胰岛素抵抗相关指标[空腹血糖(FPG)、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)、抵抗素]的变化。结果治疗后,两组TG、TC与LDL-C水平均显著降低(P<0.05),且观察组明显低于对照组(P<0.05);两组HDL-C水平显著升高(P<0.05),且观察组明显高于对照组(P<0.05)。治疗后,两组hs-CRP、IL-6及TNF-α水平均明显降低(P<0.05),且观察组显著低于对照组(P<0.05)。治疗后,两组VEGF、CEC水平均显著降低(P<0.05),且观察组明显低于对照组(P<0.05);两组EPCs水平明显升高(P<0.05),且观察组显著高于对照组(P<0.05)。治疗后,两组FPG、FIns、HOMA-IR及抵抗素水平均明显降低(P<0.05),且观察组明显低于对照组(P<0.05)。结论大剂量阿托伐他汀可有效改善糖尿病合并不稳定型心绞痛患者PCI后血脂水平,降低机体炎性反应及胰岛素抵抗,减轻血管内皮损伤。Objective To investigate the effects of high-dose atorvastatin on blood lipids and inflammation after percutaneous coronary intervention(PCI)in patients with diabetes mellitus complicated with unstable angina pectoris.Methods Randomized digital method was performed.166 patients with diabetes mellitus complicated with unstable angina diagnosed by coronary angiography(GAG)and PCI were divided into two groups,83 patients in each group.Both groups were given conventional drug treatment.The conventional control group was given a dose of 20 mg/d atorvastatin and the observation group was added to 40 mg/d.Comparison of blood lipids(TG,TC,LDL-C,HDL-C),inflammation(hs-CRP,IL-6,TNF-α),vascular endothelium-related indicators(VEGF,CEC,EPCs)and island resistance before and after treatment Changes in related indicators(FPG,FIns,HOMA-IR,resistin).Results After treatment,the levels of TG,TC and LDL-C in the two groups were significantly decreased(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The HDL-C levels in the two groups were significantly increased(P<0.05),and the observation group was significantly higher than the control group(P<0.05).After treatment,the levels of hs-CRP,IL-6 and TNF-αin the two groups were significantly reduced(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,the levels of VEGF and CEC were significantly reduced in the two groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The levels of EPCs in the two groups were significantly increased(P<0.05),and the observation group was significantly higher.In the control group(P<0.05).After treatment,the levels of FPG,FIns,HOMA-IR and resistin were significantly decreased in the two groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05).Conclusion High-dose atorvastatin can effectively improve the blood lipid level,reduce the body′s inflammatory response and insulin resistance,r

关 键 词：糖尿病 心绞痛 不稳定型 阿托伐他汀钙 经皮冠状动脉介入治疗 血脂异常 炎症 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]