阿托伐他汀对冠心病合并糖尿病患者糖脂代谢的影响  

Effects of Atorvastatin on Glucose and Lipid Metabolism in Patients with Coronary Heart Disease and Diabetes Mellitus

作　　者：王丽杰 郭艳娇 吕晓翠 王文州[1] 李文慧[1] WANG Li-jie;GUO Yan-jiao;LV Xiao-cui;WANG Wen-zhou;LI Wen-hui(Department of Cardiology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)

机构地区：[1]河北北方学院附属第二医院心内科,河北张家口075100

出　　处：《河北北方学院学报（自然科学版）》2022年第10期15-19,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的探讨阿托伐他汀对冠心病合并糖尿病患者糖脂代谢的影响,为阿托伐他汀的临床应用提供参考。方法97例冠心病合并糖尿病患者按治疗方案不同分为阿托伐他汀低剂量(Ato-L)组33例、阿托伐他汀中剂量(Ato-M)组32例及阿托伐他汀高剂量(Ato-H)组32例,3组患者均给予常规冠心病、糖尿病治疗;Ato-L组加用阿托伐他汀钙片每晚1次,每次10 mg,Ato-M组每次20 mg,Ato-H组每次40 mg。治疗6个月后观察各组患者FPG、HbA_(1c)、TC、TG、LDL-C、HDL-C、CRP及2hPG水平变化。结果治疗前各组FPG、HbA_(1c)、2hPG、TC、TG、LDL-C、HDL-C及CRP水平差异无统计学意义(P>0.05)。治疗后各组FPG、HbA_(1c)、2hPG、TC、TG、LDL-C及CRP水平较治疗前均下降,HDL-C水平较治疗前升高(P<0.05);Ato-H组FPG、HbA_(1c)、2hPG、HDL-C高于Ato-L组及Ato-M组(P<0.05),TC、TG、LDL-C及CRP低于Ato-L组及Ato-M组(P<0.05);Ato-M组HDL-C高于Ato-L组(P<0.05),TC、TG、LDL-C及CRP低于Ato-L组(P<0.05)。结论高剂量阿托伐他汀治疗冠心病合并糖尿病增加了升高FPG、2hPG、HbA_(1C)的风险,但中小剂量对血糖未见明显影响,降脂效果明显,临床收益大于风险,用药相对安全。Objective To investigate the effect of atorvastatin on glucose and lipid metabolism in coronary heart disease complicated with diabetes,and to provide reference for the clinical application of atorvastatin.Methods A total of 97 patients with coronary heart disease and diabetes were divided into atorvastatin low-dose(Ato-L)group(33 cases),atorvastatin medium-dose(Ato-M)group(32 cases),high-dose atorvastatin group,(Ato-H)group(32 cases)according to different treatment regimens.All patients were given conventional coronary heart disease and diabetes treatment;Ato-L group were added atorvastatin calcium tablets once a night,10 mg each time,Ato-M group 20 mg each time,and Ato-H group 40 mg each time.After 6 months of treatment,the levels of FPG,HbA_(1c),TC,TG,LDL-C,HDL-C,CRP and 2hPG in each group were observed.Results There was no significant difference in the levels of FPG,HbA_(1c),2hPG,TC,TG,LDL-C,HDL-C and CRP among the groups before treatment(P>0.05).After treatment,the levels of FPG,HbA_(1c),2hPG,TC,TG,LDL-C and CRP in each group were decreased compared with those before treatment,and the levels of HDL-C were increased compared with those before treatment(P<0.05);FPG,HbA_(1c),2hPG and HDL-C in Ato-H group were higher than those in Ato-L group and Ato-M group(P<0.05).TC,TG,LDL-C and CRP were lower than those in Ato-L group and Ato-M group(P<0.05);HDL-C in Ato-M group was higher than that in Ato-L group(P<0.05),while TC,TG,LDL-C and CRP were lower(P<0.05).Conclusion Atorvastatin in the treatment of coronary heart disease complicated with diabetes increases the risk of increasing FPG and HbA1C,but the long-term application of medium and small doses has no significant effect on blood sugar.The lipid-lowering effect is obvious,and the clinical benefits far outweigh the risks.Long-term use is relatively safe.

关 键 词：阿托伐他汀 冠心病 糖尿病 总胆固醇 低密度脂蛋白-胆固醇 高密度脂蛋白胆固醇 空腹血糖 

分 类 号：R541.4[医药卫生—心血管疾病]