替米沙坦联合瑞舒伐他汀治疗糖尿病合并冠心病对患者外周胰岛素抵抗、糖化血红蛋白、脂蛋白和心肌缺血的影响  

Effects of telmisartan combined with rosuvastatin on peripheral insulin resistance,glycosylated hemoglobin,lipoproteins and myocardial ischemia in diabetic patients with coronary heart disease

作　　者：王晶[1] 刘易婷 刘哲[1] WANG Jing;LIU Yiting;LIU Zhe(Affiliated Hospital of Yan’an University,Yan’an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《陕西医学杂志》2022年第5期595-598,共4页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2018SF-075)。

摘　　要：目的:探究替米沙坦联合瑞舒伐他汀治疗糖尿病合并冠心病对患者外周胰岛素抵抗、糖化血红蛋白、脂蛋白和心肌缺血的影响。方法:184例糖尿病合并冠心病患者随机分为观察组和对照组各92例,对照组实施瑞舒伐他汀口服治疗方案,观察组在对照组基础上联合替米沙坦治疗,比较治疗前及治疗16周后两组糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、脂代谢指标[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)]、心功能指标[左室舒张末容积(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、血液流变学指标(全血黏度、血浆黏度、纤维蛋白原)。结果:治疗16周后,两组FPG、2hPG、HbA1c、HOMA-IR、LDL-C、TG、LVESD、LVEDD、全血黏度、血浆黏度、纤维蛋白原水平显著降低(均P<0.05),两组HDL-C、LVEF水平均显著升高(均P<0.05),观察组变化幅度较对照组显著(均P<0.05)。结论:替米沙坦联合瑞舒伐他汀治疗糖尿病合并冠心病可有效减轻患者外周胰岛素抵抗,改善糖脂代谢情况及血液流变情况,同时可进一步减轻心肌缺血情况,具有较高临床应用价值。Objective:To explore the effects of telmisartan combined with rosuvastatin on peripheral insulin resistance,glycosylated hemoglobin,lipoproteins and myocardial ischemia in diabetic patients with coronary heart disease.Methods:A total of 184 patients with diabetes mellitus complicated with coronary heart disease were randomly divided into observation group and control group,with 92 cases in each group.The control group was treated with rosuvastatin orally.The observation group was treated with telmisartan on the basis of the control group.The glucose metabolism indexes(FPG,2hPG,HbA1c),insulin resistance index(HOMA-IR),lipid metabolism indexes(LDL-C,HDL-C,TG),cardiac function indexes(LVESD,LVEDD,LVEF),hemorheological parameters(whole blood viscosity,plasma viscosity,fibrinogen)were compared between two groups.Results:After 16 weeks of treatment,in two groups,the levels of FPG,2hPG,HbA1c,HOMA-IR,LDL-C,TG,LVESD,LVEDD,whole blood viscosity,plasma viscosity and fibrinogen decreased,while the levels of HDL-C and LVEF increased,and the changes of indexes in observation group were significantly greater than those in control group(all P<0.05).Conclusion:Telmisartan combined with rosuvastatin in the treatment of diabetes mellitus with coronary heart disease can effectively relieve the peripheral insulin resistance,improve the glucolipid metabolism and hemorheology,and further alleviate the myocardial ischemia.

关 键 词：糖尿病 冠心病 替米沙坦 瑞舒伐他汀 胰岛素抵抗 糖化血红蛋白 心肌缺血 

分 类 号：R587.2[医药卫生—内分泌]