阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

营养支持对急性脑血管病患者预后的影响

目的 探讨营养支持对急性脑血管病患者预后的影响.方法 选择急性脑血管病住院患者98例,完全随机分为营养支持组(46例)及对照组(52例),分别测定患者入院时、入院后2周时CH、TC、血红蛋白、血清白蛋白情况,并对2组感染性并发症发生率及神经功能康复程度进行比较.结果 入院后2周对照组CH、TC、血清白蛋白、血红蛋白值明显低于营养支持组[(3.2±1.2)mol/L比(4.5±1.2)mol/L;(1.4±0.3)mol/L比(1.6±0.3)mol/L;(35±6)g/L比(38±5)g/L;(108±11)g/L比(120±9)g/L,P<0.01],各营养指标与入院时相比,亦明显下降(P<0.05).营养支持组肺感染、尿路感染的发生率低于对照组[10.8%(5/46)比12.2%(18/52);9.4%(4/46)比10.6%(16/52),P<0.05],神经功能康复程度好于对照组[(13.6±5.5)分比(8.1±4.1)分,P<0.01].结论 营养支持治疗可改善急性脑血管病患者的营养状况,减少并发症的发生,改善其预后.

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Objective To explore the effect of nutritional support on the prognosis of patients with acute cerebrovascular disease.Methods Ninety-eight cases of hospitalized patients with acute cerebrovascular disease were selected and divided into 46 cases of the nutritional support group and 52 cases of the control group,the condition of triglycefides,cholesterol,hemoglobin,serum albumin were contrasted when admission,2 weeks after admission and the incidence of infectious complications and the degree of neurological function recovery were compared between the two groups.Results Two weeks after admission,various nutritional indicators of the control group were significantly lower than the nutritional support group[(3.2±1.2)mmol/L vs(4.5±1.2)mo]/L;(1.43±0.31)mol/L vs(1.62±0.33)mol/L;(35±6)g/L vs(38±5)g/L;(108±11)g/L vs(120±9)g/L,P<0.01].The infection rate of pulmonary and urinary tract of the nutritional support group was lower than the control group[10.8%(5/46)vs 12.2%(18/52);9.4%(4/46)vs 10.6%(16/52),P<0.05];the degree of neurological function recovery was better than the control group[(13.6±5.5)scores vs(8.1±4.1)scores,P<0.01].Conclusion Early nutritional support can improve the nutfiture status of patients,reduce the incidence of complications and improve the prognosis.     

青年女性冠心病患者血清尿酸与冠状动脉病变的关系

目的 探讨青年女性冠心病患者血清尿酸水平与冠状动脉病变程度的关系.方法 回顾性分析2002年1月至2011年1月于我院住院经冠状动脉造影明确诊断冠心病的青年女性患者183例的临床资料.根据冠状动脉造影结果,记录为单支病变变组(123例)、双支病变组(38例)和三支病变组(22例).观察冠心病危险因素与冠状动脉病变程度的关系.结果 ①在单支、双支和三支病变组,血清尿酸水平竺差异有统计学意义[分别为(263.88±66.08)、(263.99±71.39)、(312.62+75.86)μmol/L,P<0.05].②双支、三支病变组lnTG、TC及LDL-C水平明显高于单支病变组[分别为(0.44±0.56)、(0.62±0.46)mmol/L比(0.29±0.46)mmol/L,(4.68±1.37)、(5.60±1.53)mmol/L比(4.14±0.93)mmol/L,(2.87±1.15)、(3.76±1.28)mmol/L比(2.48±0.74)mmol/L,均P<0.05].③Logistic回归分析显示,影响冠状动脉多支病变的独立危险因素依次为TG、LDL-C水平(P<0.05);而尿酸水平不是冠状动脉多支病变的独立危险因素.结论 青年女性的血清高尿酸水平与冠心病患者冠状动脉的病变程度有一定的相关性.

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Objective To study the relation between serum uric acid and the severity of coronary artery le-sion in young women. Methods One hundred and eighty-three young women patients underwent coronary angiogra-phy between January 2002 and January 2011 were selected. According to the results of coronary angiography, they were divided into three groups: the single, double and triple vessel lesions. The relation between body mass index (BMI) , systolic blood pressure( SBP) , diastolic blood pressure(DBP) , heart rates(HR) , serum uric acid(UA) , fasting blood glucose(FBG) , triglyceride(TG) , total cholesterol(TC), high density lipoprotein cholesterol(HDL-C) , low density lipoprotein cholesterol (LDL-C) with severity of coronary artery disease (CAD) were analyzed. Results The UA level in the triple vessel lesions group was significantly higher than that in the single and double vessel le-sions group[(312.62±75.86)μmol/L vs(263.88±66.08) ,(263.99±71.39) μmol/L, P<0.05]. In the mul-tiple vessel lesions group, lnTG, TC and LDL-C were significantly higher than those in the single vessel lesions group[(0.44±0.56) , (0.62 ±0.46)mmol/L vs(0.29±0.46)mmol/L;(4.68±1. 37) , (5. 60±1.63)mmol/L vs(4.14 ±0.93)mmol/L;(2. 87 ± 1.15) , (3. 76 ± 1.28)mmol/L vs(2. 48±0. 74)mmol/L] , but there was no significant difference of UA between the two groups. According to Logistic regression analysis, the factors related with the multiple vessel lesions CAD was TG, LDL-C(P<0.05) , meanwhile the UA was not an independent risk factor. Conclusion In young women patients, high UA level is related to severe coronary artery vessel lesions.     

阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

目的 观察阿托伐他汀钙对高血压病患者血脂异常的疗效和安全性及对高敏C反应蛋白(hs-CRP)的影响.方法 观察128例高血压伴有血脂异常的患者,其中治疗组68例,在降压治疗和低脂饮食的基础上,给予阿托伐他汀钙20 mg/d,睡前服,治疗12周;对照组60例,予降压治疗和低脂饮食.测定2组治疗前后的血压、TG、TC、LDL-C、HDL-C、极低密度脂蛋白胆固醇(VLDL-C)、hs-CRP、Cr、ALT、肌酸激酶水平,并进行比较分析.结果 治疗组用药后与用药前比较,血压无明显改变,TG下降[(1.6±1.2)mmol/L比(2.0±0.9)mmoL/L,P＜0.05],HDL-C有升高的趋势,但差异无统计学意义,TC下降[(4±1)mmol/L比(6±1)mmol/L,P＜0.01),LDL-C下降[(3±1)mmol/L比(4±1)mmol/L,P＜0.01],hs-CRP明显下降[(2.3±1.5)mg/L比(5.3±2.9)mg/L,P＜0.01].仅2例患者出现血清肌酸激酶的轻度升高,1个月后复查均恢复正常.与对照组治疗后比较,治疗组的TC、LDL-C、TG、VLDL-C和hs-CRP明显降低,差异有统计学意义(P＜0.05或P＜0.01),SBP、DBP、Cr及ALT均差异无统计学意义.结论 阿托伐他汀钙可有效地改善高血压病患者血脂异常和炎症状态,而且是安全的.

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Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

瑞舒伐他汀短期干预对急性冠状动脉综合征患者高敏C反应蛋白及血管性血友病因子和内皮依赖性血管功能的影响

目的 研究瑞舒伐他汀短期干预对急性冠状动脉综合征(ACS)患者血清高敏C反应蛋白(hsCRP)和血管性血友病因子(vWF)水平以及内皮依赖性血管舒张功能的影响.方法 将62例ACS患者完全随机分为他汀组和常规组,各31例,常规组施以常规和安慰剂治疗,他汀组在常规治疗基础上加服瑞舒伐他汀20 mg/d,疗程8周,并于治疗前后分别测定血清hs-CRP、vWF和内皮依赖性血管舒张功能的变化.结果 治疗8周后,常规组的hs-CRP、TC、TG、HDL-C、LDL-C、vWF水平分别为(12.41±5.36)mg/L、(6.31±0.80)mmol/L、(2.65±0.57)mmol/L、(1.33±0.28)mmol/L、(4.20±0.98)mmol/L、(150.68±27.85)%.他汀组上述指标分别为(6.15±2.07)mg/L、(5.87±0.63)mmol/L、(2.38±0.48)mmol/L、(1.48±0.27)mmol/L、(2.91±0.92)mmol/L、(127.46±18.25)%.他汀组治疗后hs-CRP、TG、HDL-C、LDL-C、vWF与治疗前比较,差异有统计学意义(P＜0.01).他汀组治疗后TC、HDL-C与常规组治疗后比较,差异有统计学意义(P＜0.05);他汀组治疗后hs-CRP、LDL-C、vWF与常规组治疗后比较,差异有统计学意义(P＜0.01).结论 应用瑞舒伐他汀对ACS进行干预,在有效调脂的同时可显著降低hs-CRP和vWF水平,改善血管内皮功能,有利于动脉粥样硬化斑块的稳定.

Abstract：

Objective To study the effects of short-term rosuvastatin therapy on high sensitive C-reactive protein (hs-CRP), von Willebrand factor(vWF) and endothelium dependent vasodilatation function in patients with acute coronary syndrome(ACS). Methods Totally 62 patients with ACS were randomly divided into the statin group (n =31 ) and control group (n =31 ). The patients in statin group were treated with Rosuvastain 20 mg/day besides conventional therapy; the patients in control group were treated only with conventional therapy and placebo.The course of therapy was 8 weeks. Plasma levels of hs-CRP and vWF, endothelium dependent vasodilatation function were measured before and after treatment. Results The plasma levels of hs-CRP and vWF in statin group were decreased significantly (P ＜0.01 ), also endothelium dependent vasodilatation function were improved than the patients in control group after 8 weeks. Conclusion It is suggested that short-term therapy with rosuvastatin in patients with ACS could reduces the levels of hs-CRP and vWF and improve the function of endothelium dependent vasodilatation, thus it promotes the stabilization of atheroselerotic plaque.     

脑心通对急性冠脉综合征患者血脂及超敏C反应蛋白的影响

Objective To investigate the effects of atorvastatin combined with Naoxintong capsules on serum lipid level and hish sensitivity C-reactive protein(hs-CRP)in patients with acute coronary syndrome(ACS).Methods 82 ACS patients were randomly divided into observation group(10 mg/d of atorvastatin and 4 capsules 3 times of Naoxintong daily,n=41) and control group(20 mg/d of simvastatin daily,n=41).The levels of serum lipid and hs-CRP were detected before and after treatment.Results 8 weeks after treatment,the levels of serum hpid[TC (4.21±0.87)mmol/L,TG(1.99±0.48)mmol/L,LDL-C(2.71±0.83) mmol/L] and serum hs-CRP(5.63±1.38)mg/L in observation group were significantly lower than those in control group[TC(4.89±0.91)mmol/L,TG (2.58±0.52)mmol/L,LDL-C(3.28±0.89)mmol/L],and serum level HDL-C(1.89±0.47)mmol/L was higher than that in control group(1.63±0.45)mmol/L(t=2.55-4.36,P<0.01～0.05).Conclusion Adjuvant therapy of Naoxintong could promote the levels of serum lipid and hs-CRP in patients with ACS.and offer a better therapeutic effect in these patients.     

脑心通对急性冠脉综合征患者血脂及超敏C反应蛋白的影响

Objective To investigate the effects of atorvastatin combined with Naoxintong capsules on serum lipid level and hish sensitivity C-reactive protein(hs-CRP)in patients with acute coronary syndrome(ACS).Methods 82 ACS patients were randomly divided into observation group(10 mg/d of atorvastatin and 4 capsules 3 times of Naoxintong daily,n=41) and control group(20 mg/d of simvastatin daily,n=41).The levels of serum lipid and hs-CRP were detected before and after treatment.Results 8 weeks after treatment,the levels of serum hpid[TC (4.21±0.87)mmol/L,TG(1.99±0.48)mmol/L,LDL-C(2.71±0.83) mmol/L] and serum hs-CRP(5.63±1.38)mg/L in observation group were significantly lower than those in control group[TC(4.89±0.91)mmol/L,TG (2.58±0.52)mmol/L,LDL-C(3.28±0.89)mmol/L],and serum level HDL-C(1.89±0.47)mmol/L was higher than that in control group(1.63±0.45)mmol/L(t=2.55-4.36,P<0.01～0.05).Conclusion Adjuvant therapy of Naoxintong could promote the levels of serum lipid and hs-CRP in patients with ACS.and offer a better therapeutic effect in these patients.     

瑞舒伐他汀对急性冠状动脉综合征伴高脂血症患者血脂及炎性因子的影响

目的 观察瑞舒伐他汀治疗急性冠状动脉综合征(ACS)伴高脂血症的I临床疗效及安全性.方法 2010年9月至2011年1月就诊于北京安贞医院心内科的ACS伴高脂血症患者90例,完全随机分为辛伐他汀组(药物使用量:10 mg/d,n=42)和瑞舒伐他汀组(药物使用量:10 mg/d,n=48),疗程均为1周,观察治疗前后各项主要血脂指标变化率、达标率及血清肿瘤坏死因子仪(TNF-a)及C反应蛋白(CRP)变化.结果 在降低TC、LDL-C、脂蛋白(Lp)(a)及升高HDL-C方面,瑞舒伐他汀组优于辛伐他汀组[TC:瑞舒伐他汀组治疗后(4.80±0.36)mmol/L、治疗前(6.80±0.27)mmol/L、变化率-29%,辛伐他汀组分别为(5.50±0.19)mmoL/L、(6.90±0.21)mmol/L、-21%;LDL-C:瑞舒伐他汀组治疗后(2.00±0.26)mmol/L、治疗前(4.50±0.10)mmol/L、变化率-56%,辛伐他汀组(3.30±0.27)mmol/L、(4.00±0.21)mmol/L、-18%;Lp(a):瑞舒伐他汀组治疗后(72±15)mmol/L、治疗前(115±21)mmol/L、变化率一37%,辛伐他汀组(101±24)mmol/L、(108±21)mmoL/L、-6%;HDL-C:瑞舒伐他汀组治疗后(0.98±0.05)mmol/L、治疗前(0.72±0.04)mmol/L、变化率+36%,辛伐他汀组(0.90±0.02)mmol/L、(0.80±0.05)mmoL/L、+13%].2组对肝、肾功能的影响差异无统计学意义.舒伐他汀治疗组降低炎症标志物TNF-a和CRP水平强于辛伐他汀组[TNF-a:瑞舒伐他汀组治疗后(62+20)U/ml、治疗前(90±10)U/ml、变化率-31%,辛伐他汀组分别为(71±15)U/ml、(86±13)U/ml、-17%;CRP:瑞舒伐他汀组治疗后(2.7+1.6)mg/L、治疗前(4.8±1.8)mg/L、变化率-44%,辛伐他汀组(4.0±1.3)ms/L、(5.2±1.5)ms/L、-23%].2组患者治疗期间未出现明显的、难以耐受的不良反应.结论 瑞舒伐他汀(10 mg/d)可以更全面地调理ACS伴混合性高脂血症患者的血脂异常,尤其是在升高HDL-C、降低LDL-C方面,并具有良好的安全性.瑞舒伐他汀具有较强抗炎作用.

Abstract：

Objective To investigate the effects and the safety of rosuvastiatin in actute coronary syndrome (ACS)complicated with hyperlipidemia.Methods Ninety patients with hyperlipidernia were randomly assigned into simvastatin group (n=42) and rosuvastatin group(n=48).They were treated with simvasmtin and rosuvastatin respeetively 10 mg/d and 10 mg/d for 1 week.Lipid profile and physical laboratory investigations for adverse effects were also assessed.Serum levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol(HDL-C)and Lp(a)were measured at the end of 1 weeks of the trial period. Results Rosuvastatin treatment was more effective than simvastatin in reducing serunl levels of TC,LDL-C and Lp(a)and in raising HDL-C.The difference of liver and kidney function of 2 groups was not statistically significant.The abilities of atorvastatin treatment group in decreasing inflammatory markers in TNF-a and CRP levels were stronger than those in the simvastatin group.Conclusion Rosuvastatin has full-scale lipid-regulating effects,especially in reducing serum levels of TC,LDL-C and Lp(a) and in raising HDL-C.     

阿托伐他汀对老年高脂血症患者颈动脉斑块的影响

目的 探讨阿托伐他汀对老年高脂血症患者颈动脉斑块的影响.方法 155例伴有颈动脉斑块的老年高脂血症患者应用阿托伐他汀20 mg/d治疗.治疗前、治疗后6个月检测血脂水平,经彩色多普勒超声检测颈动脉内膜中层厚度(IMT)、斑块最大厚度(Tmax)及最大面积(Smax).结果 治疗后患者TC、TG、LDL-C较治疗前明显下降[(4.07±0.52)mmol/L比(5.83±0.76)mmol/L,(1.65±0.24)mmol/L比(2.18±0.37)mmol/L,(2.98±0.31)mmol/L比(3.75±0.49)mmol/L,均P＜0.05)],HDL-C较治疗前明显升高[(1.27±0.19)mmol/L(0.94±0.15)mmol/L,P＜0.05];颈动脉IMT、Tmax、Smax较治疗前明显下降[(1.15±0.13)mm比(1.41±0.19)mm,(2.01±0.19)mm比(2.29±0.24)mm,(13.61±2.87)mm2比(16.75±3.06)mm2,均P＜0.05].结论 阿托伐他汀具有延缓动脉粥样硬化进程及稳定斑块的作用.

Abstract：

Objective To study the effects of atorvastatin on atherosclerotic plaques in the elderly patients with hyperlipoidemia. Methods Atorvastatin 20 mg/d was administered in 55 cases of atherosclerotic plaques in elderly patients with hyperlipoidemia. The levels of blood fat and carotid intima-media thickness (IMT) , maximal plaque thickness (Tmax) and maximum size (Smax) were observed by Color Doppler ultrasound before and after 6 months treatment. Results The levels of TC, TG, LDL-C in patients after treatment were significant lower than those before treatment [(4.07±0.52) mmol/L vs (5. 83 ±0. 76)mmol/L, (1. 65 ±0.24)mmol/L vs (2. 18 ± 0.37)mmol/L, (2.98 ±0. 31)mmol/L vs (3.75 ±0.49)mmol/L,P＜0. 05] , HDL-C was significant higher than that before treatment [(1.27 ±0.19) mmol/L vs(0.94 ±0.15) mmol/L,P＜0.05]. The carotid IMT, Tmax, Smax were significantly lower than those before treatment [(1. 15 ±0.13) mm vs (1.41±0.19) mm, (2.01 ± 0.19)mm vs (2.29 ±0.24)mm,(13.61 ±2.87)mm2 vs (16.75 ±3.06)mm2,P＜0.05]. Conclusion Atorvastatin can delay the process of atherosclerosis and stabilize plaques.     

瑞舒伐他汀对血脂正常的早期糖尿病肾病患者肾脏保护作用观察

目的 观察瑞舒伐他汀对血脂正常的早期糖尿病肾病(DN)患者肾脏的作用.方法 62例早期DN患者完全随机分为研究组和对照组,各31例.对照组给予常规降糖治疗及厄贝沙坦150 nmg,2次/d.研究组在对照组治疗基础上,给予瑞舒伐他汀10 mg/d,口服,共12周.治疗前及治疗12周后测定2组患者空腹血清TC、HDL-C、LDL-C、TG、高敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbAlc)、BUN、Cr、尿酸、ALT、AST及肌酸激酶(CK)水平,检测24h尿白蛋白排泄率(UEAR)和尿β2微球蛋白(β2MG).结果 2组治疗前后TC、HDL-C、LDL-C、TG、HbAlc、ALT、AST及CK水平差异均无统计学意义;与治疗前比较,2组治疗后尿β2 MG、UEAR均明显下降[(o.3±0.1) mg/L比(0.6±0.2) mg/L,(0.4士0.1)mg/L比(0.6±0.2) mg/L;( 132.6±14.2) mg/24 h比(206.1±19.7)mg/24 h,(162.2±18.5) mg/24 h比(203.2±21.4) mg/24 h,均P＜0.05],研究组hs-CRP水平也明显降低[(3.6±1.6)mg/L比(4.5±1.5) mg/L,P＜0.05],但研究组尿β2MG、UEAR及hs-CRP下降幅度较对照组明显(P＜0.05).结论 瑞舒伐他汀具有非依赖降脂的肾保护作用机制.     

阿托伐他汀对不稳定型心绞痛患者血脂与血管内皮功能的影响

目的观察阿托伐他汀对不稳定型心绞痛患者的血脂、血管内皮生长因子（VEGF）和NO的影响。方法选择2011年5—12月不稳定型心绞痛患者30例,口服阿托伐他汀片40mg／次,1次／d,连用60d。分别于清晨空腹抽取治疗前和治疗60d后患者的肘静脉血,检测血清TC、LDL—C、HDL—C、TG、VEGF和NO的水平,比较治疗前后的变化。结果阿托伐他汀治疗60d后患者TC、LDL—C、TG水平较治疗前明显降低,差异有统计学意义[TC：（4．7±0．9）mmol／L比（7．0±0．5）mmol／L,LDL—C：（2．85±0．57）mmol／L比（4．45±0．26）mmoL／L,TG：（1．8±0．5）mmoL／L比（2．6±0．3）nllno]／／L,均P〈0．01];HDL—C、VEGF和NO水平较治疗前明显升高,差异有统计学意义[HDL—C：（1．49-4-0．13）mmol／L比（1．32±0．15）mmol／L,VEGF：（308±47）ng／L比（17±22）ng／L,NO：（82±13）txmol／L比（61±9）mmol／L,均P〈0．01]。结论阿托伐他汀治疗不稳定型心绞痛不仅具有降脂作用,而且对改善血管内皮功能具有重要意义。     

格列美脲治疗2型糖尿病伴肥胖患者的临床效果及药理分析

目的 探讨2型糖尿病伴肥胖患者施以格列美脲治疗的临床效果,并作药理分析。方法 46例2型糖尿病伴肥胖患者,根据随机数字表法分为观察组和对照组,每组23例。对照组患者给予格列吡嗪缓释片治疗,观察组患者给予格列美脲片治疗。比较两组患者治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]及体质量指数(BMI)。结果 治疗后,观察组患者FPG、2 h PG、FINS、HbA1c水平分别为(6.04±0.43)mmol/L、(11.12±2.52)mmol/L、(657.84±10.37)pmol/L、(6.46±0.58)%,均低于对照组的(7.45±0.27)mmol/L、(14.24±2.09)mmol/L、(704.29±11.09)pmol/L、(8.53±0.79)%,差异均具有统计学意义(P<0.05)。观察组患者TC、TG、LDL-C、BMI水平分别为(3.24±0.79)mmol/L、(1.88±0.69)mmol/L、(1.96±0.48)mmol/L、(23.05±2.55)kg/m2,均低于对照组的(4.75±0.38)mmol/L、(2.35±0.75)mmol/L、(2.95±0.66)mmol/L、(27.76±4.10)kg/m2,差异均具有统计学意义(P<0.05)。结论 以格列美脲治疗2型糖尿病伴肥胖患者,可使患者血糖及血脂水平得以有效控制,同时可减轻其肥胖程度,具较高应用价值。     

川崎病患儿血脂水平与冠状动脉损害的关系研究

目的 探讨川崎病患儿血脂水平与冠状动脉损害的相关性.方法 62例川崎病患儿按照超声心电图显示分为冠状动脉损害组(28例)和非冠状动脉损害组(34例),另选取同期健康体检正常儿童62例作为对照组.比较三组儿童的血脂水平及与冠状动脉损害的关系.结果 冠状动脉损害组和非冠状动脉损害组总胆固醇(TC)水平分别为(5.32±1.74) mmol/L、(5.24±1.67) mmol/L、甘油三酯(TG)分别为(1.67±0.79) mmol/L、( 1.74±0.65) mmoL/L、低密度脂蛋白胆固醇(LDL-C)分别为(2.87±1.14) mmoL/L、(2.72±1.08) mmol/L均明显高于对照组的(3.08±1.28)mmoL/L、(1.12±0.56) mmol/L、(2.37±1.06)mmol/L(t=1.70、1.66、1.71,均P＜0.05),高密度脂蛋白胆固醇(HDL-C)分别为(1.03±0.31、1.08±0.57) mmol/L明显低于对照组的(1.65±0.92) mmol/L(t=1.54,P＜0.05).经过治疗后,非冠状动脉损害组TC、TG、LDL-C水平明显降低(t=1.76、1.88、1.72,均P＜0.05),HDL-C水平明显升高(t=1.90,P＜0.05);冠状动脉损害组治疗前后血脂水平变化差异均无统计学意义(均P＞0.05).结论 川崎病患儿存在着明显的血脂代谢紊乱,动态监测患儿血脂水平变化可作为川崎病并发冠状动脉损害的早期诊断指标.     

部队离退休老干部血脂水平调查及其与吸烟的关系分析

目的 调查某部干休所老干部血脂水平并分析其与吸烟的关系.方法 140名老年人根据年龄分为A组47名(65～69岁)、B组49名(70 ～79岁)及C组44名(80 ～89岁)3组,比较其血液中胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的水平.根据是否吸烟,分为E组(吸烟组)及F组(不吸烟组)两组,比较TC、TG、LDL-C、HDL-C的水平及两组2型糖尿病的患病率.结果 该干休所老年人高脂血症发生率为38.33％;各年龄段血脂水平未见明显差异;吸烟组与不吸烟组相比,TG[(1.64±0.48) mmol/L与(1.53 +0.66) mmol/L,P ＜0.05]、TC[(5.31±1.27) mmol/L与(5.15±0.79) mmol/L,P＜0.05]、LDL-C[ (3.86±0.88) mmol/L与(3.14±1.10) mmol/L,P＜0.05]较高,HDL-C[( 1.47±0.410) mmol/L与(1.63±0.55) mmoL/L,P＜0.05]较低.2型糖尿病的发病率两组比较差异显著(10.87％与5.32％,P＜0.05).结论 吸烟的老年人脂类代谢紊乱严重,吸烟可使老年人血中脂质和脂蛋白向不利于健康方向变化,吸烟组的老年人患动脉粥样硬化性心血管病和2型糖尿病的风险高.     

阿卡波糖+二甲双胍治疗2型糖尿病伴高脂血症的疗效和安全性分析

目的分析阿卡波糖+二甲双胍治疗2型糖尿病伴高脂血症的疗效和安全性。方法108例2型糖尿病伴高脂血症患者作为研究对象,采用随机数字表法分为对照组和观察组,每组54例。对照组患者接受二甲双胍治疗,观察组患者接受阿卡波糖联合二甲双胍治疗。对比两组患者不良反应发生情况、治疗后血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平、治疗后血脂[血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平。结果观察组不良反应发生率9.26%高于对照组的7.41%,但比较差异无统计学意义(P>0.05)。观察组患者治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白分别为(8.75±0.86)mmol/L、(12.55±1.14)mmol/L、(6.86±0.67)%,均低于对照组的(12.87±1.19)mmol/L、(15.29±1.38)mmol/L、(9.00±0.85)%,差异统计学有意义(P<0.05)。观察组患者治疗后的TC、TG、LDL-C分别为(7.09±0.68)、(1.63±0.15)、(3.35±0.31)mmol/L均低于对照组的(8.82±0.87)、(3.14±0.29)、(4.39±0.42)mmol/L,HDL-C(1.55±0.13)mmol/L高于对照组的(1.15±0.10)mmol/L,差异统计学有意义(P<0.05)。结论2型糖尿病伴高脂血症患者接受阿卡波糖联合二甲双胍治疗,能够有效降低其血脂水平和血糖水平,且治疗期间的不良反应较少。     

老年糖尿病患者高尿酸血症与胰岛素抵抗的关系探讨

目的探讨老年糖尿病患者高尿酸血症与胰岛素抵抗的关系。方法老年糖尿病患者75例,按照血尿酸（UA）水平分为高尿酸组（HUA）39例和正常尿酸组（NUA）36例,对两组的BMI、腰臀比（WHR）、血UA、TC、TG、LDL-C、糖化血红蛋白（HbA1c）及胰岛素水平进行分析。结果（1）HUA组TG、TC、LDL-C、胰岛素抵抗指数（HOMA-IR）均高于NUA组[（3．39±1．28）mmol／L与（1．39±0．77）mmol／L、（6．61±1．53）mmol／L与（5．15±1．57）mmol／L、（4．28±1．26）mmol／L与（2．364±1．23）mmol／L、（0．85±0．54）与（0．53±0．38）],差异均有统计学意义（t=2．129、2．012、2．175、2．009,均P〈0．05）。（2）老年糖尿病患者血UA水平与TG、TC、LDL．C及HOMA．IR呈正相关（r=0．327、0．335、0．321、0．331,均P〈0．05）。结论老年糖尿病患者血UA水平与多种因素相关,高尿酸血症与胰岛索抵抗密切相关。     

阿托伐他汀与辛伐他汀治疗高脂血症的效果对比

目的 对比阿托伐他汀与辛伐他汀治疗高脂血症的效果.方法 96例高脂血症患者,随机分为观察组与对照组,每组48例.对照组使用辛伐他汀治疗,观察组使用阿托伐他汀治疗.比较两组患者的临床治疗效果,治疗前后的血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平,...