不同剂量瑞舒伐他汀在急性冠脉综合征合并糖尿病患者的疗效及安全性观察

目的：探讨不同剂量瑞舒伐他汀对急性冠脉综合征（ACS）合并糖尿病患者的临床疗效及对血清中高敏C反应蛋白（hs-CRP）、血糖的影响。方法选择2012年8月至2014年8月于我院心内科住院的164例ACS合并糖尿病患者，随机分为试验组和对照组，每组82例，在控制血糖和低脂饮食的基础上，试验组自入院始服用瑞舒伐他汀20 mg/d，对照组自入院始服用瑞舒伐他汀10mg/d，观察住院期间及4周12周血脂情况及肝肾功能、肌酶的变化，同时采用酶联免疫吸附法测定两组患者服用瑞舒伐他汀前后血清hs-CRP水平及血糖、HbA1c水平。结果患者住院期间及服瑞舒伐他汀4周12周后，LDL-C水平均有显著下降，差异有统计学意义（P＜0.05）。转氨酶肌酶肝肾功能及肌溶解发生率方面差异无统计学意义（P＞0.05）试验组与对照组治疗前后血清hs-CRP水平均显著降低，对照组入院时（19.68±12.62）mg/L，4周（12.69±10.59）mg/L，12周（10.07±9.63）mg/L；实验组入院时（19.70±12.50）mg/L，4周（11.23±8.64）mg/L，12周（8.32±7.59）mg/L，组间差异有统计学意义（P＜0.01），血糖、HbA1c两组均无明显变化（P>0.05）。结论瑞舒伐他汀可显著降低ACS合并糖尿病患者LDL-C、血清hs-CRP水平，对血糖无明显影响，安全性好。

Clinical study on the effect and security of different doses of rosuvastatin therapy in acute coronary syndrome ;patients with diabetes

Objective To investigate the effect and sefety of different doses of rosuvastatin on serum high sensitivi-ty C-reactive protein and blood lipid levels,blood glucose levels in acute coronary syndrome patients with diabetes. Meth-ods A total of 164 patients with ACS complicated with diabetes were randomly assigned into the large dosage of rosuvas-tatin (20 mg/d) group(n=82) and the routine dosage of rosuvastatin group(10 mg/d) (n=82). Serum levels of blood lipid, blood glucose ,hs-CRP, HbA1c were measured with biochemistry assay 24 hours after admission. Blood lipid level, and hs-CRP were measured 4 weeks later. All above parameter were measured 12 weeks after therapy. The difference in blood lipid levels, hs-CRP, blood glucose and HbA1c was compared between the two groups. Results Among the two groups, the levels of blood lipid decreased(P<0.05). The levels of hs-CRP decreased significantly comparing with the routine dosage of rosuvastatin group(the values of control group were(19.68±12.62)mg/L,(12.69±10.59)mg/L,(10.07± 9.63)mg/L;while the test group were(19.70 ± 12.50)mg/L,(11.23 ± 8.64)mg/L and(8.32 ± 7.59)mg/L, P<0.01;but no statistically significant differences were found in FBG and HbA1c levels between the two groups(P>0.05). Conclusion Effect of early large dosage rosuvastatin therapy on serum hs-CRP levels is better than the routine dosage and is safe in pa-tients with diabetes complicated with acute coronary syndrome. Rosuvastatin has no effect on blood glucose level.