阿托伐他汀对老年2型糖尿病并高脂血症患者降脂疗效观察

目的 观察阿托伐他汀对老年2型糖尿病合并高脂血症患者降脂的疗效. 方法 研究对象每晚睡前服用阿托伐他汀片10 mg,疗程为12个月.治疗前及治疗后3、6、9、12个月分别测定血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶、谷草转氨酶、血糖、肌酐及颈总动脉、髂总动脉、股动脉的内膜中层厚度(IMT).结果阿托伐他汀治疗1年后,患者TC和LDL-C显著降低[(5.11±0.94)mmol/L至(4.46±0.98)mmol/L和(3.01±0.78)mmol/L至(2.55±0.83)mmol/L,均P<0.01],不同检测时间点LDL-C均达到治疗标准(<2.59 mmol/L),但TC只有在9个月时降至标准以下(<4.04 mmol/L).颈总动脉、髂总动脉和股动脉的IMT均呈减少的趋势,但差异无统计学意义,谷丙转氨酶、谷草转氨酶和肌酐无明显变化. 结论 阿托伐他汀对老年2型糖尿病合并高脂血症患者有明显降脂效果,不良反应小,并且具有保护血管内膜的作用.

The effect of atorvastatin on lowering lipids in elderly patients with type 2 diabetic mellitus plus hyperlipidemia

Objective To observe the effect of atorvastatin on lowering blood lipid in patients with type 2 diabetic mellitus plus hyperlipidemia. Methods All patients took 10 mg atorvastatin every night for 12 months. The levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum alanine aminotransferase (ALT), aspartate aminotransferase fAST), fasting blood glucose (FBG), creatinine (Cr), intima media thickness (IMT) of carotid artery (CA), common lilac artery (CIA) and femoral artery (CFA) were examined before and 3, 6, 9, 12 months after the treatment. Results TC [(5.11±0.94) vs. (4.46±0.98) mmol/L, P<0.01] and LDL-C [(3.01±0.78) vs. (2.55± 0.83) mmol/L, P<0. 01] were significantly decreased one year after the treatment. At different detection time points, the levels of LDL-C all reached the therapy standard (<2.59 mmol/L). But TC reached the therapy standard (<4.04 mmol/L) only at nine months after the treatment. IMT of CA, CIA and CFA were at the decreased tendency (P>0. 05). No significant changes were observed in ALT, AST and Cr. Conclusions Atorvastatin may significantly decreased the level of blood lipid with little adverse effect in elderly patients with type 2 diabetic mellitus plus hyperlipidemia, and it also has the effect of protecting the vascular intima.