吡格列酮联用阿托伐他汀对2型糖尿病患者血脂及血管内皮功能的影响

目的：观察吡格列酮联用阿托伐他汀对2型糖尿病患者血脂及血管内皮功能的影响。方法：选择2型糖尿病患者65例,随机分为对照组30例（A组）,接受常规降糖药治疗和阿托伐他汀10mg/d;实验组35例（B组）,在对照组基础上加用吡格列酮15mg/d,两组患者分别于治疗前、用药12周后检测血糖、糖化血红蛋白、血脂、血浆一氧化氮（NO）、内皮素-1（ET-1）的浓度、肱动脉内径变化率（FMD）。结果：治疗后两组患者的血糖水平均较治疗前明显降低,与治疗前比较差异有统计学意义（P〈0.01）,但两组间比较差异无统计学意义（P〉0.05）。两组患者ET-1水平有所降低（P〈0.05）,血浆NO水平和FMD均明显升高,与治疗前比较差异均有统计学意义（P〈0.01）;B组NO的升高水平和FMD较A组明显,两组比较差异均有统计学意义（P〈0.05）。治疗后两组患者体重指数均有所改善（P〈0.05,P〈0.01）。结论：吡格列酮联用阿托伐他汀能够更有效降低患者血脂水平,改善2型糖尿病患者血管内皮功能。

Effects of pioglitazone combined with atorvastatin on lipids and endothelial function in patients of type 2 diabetes mellitus

AIM： To observe the effects of pi- oglitazone combined with atorvastatin on lipids and endothelial function in patients of type 2 dia- betes mellitus. METHODS： 65 cases of type 2 diabetes patients were randomly divided into two groups, 30 cases were divided into control group （Group A）, receiving routine hypoglycemic therapy with atorvastatin 10 rag/d; the experi- mental group （Group B）, 35 cases on the basis of the control group with pioglitazone 15 mg/d. The levels of blood glucose, Glycated hemoglo- bin, lipids, nitric oxide （NO） , endothelin -1 （ET-1） and the change rate of brachial artery flow mediated dilatation （FMD）were assessed before and after 12 weeks of the treatment. RE- SULTS：Compared with pre-treatment, the levels of blood glucose after treatment were signifi- cantly decreased in two groups （P 〈 0.01）. there was no significant difference between two groups （P〉0.05）. The ET-1 levels in two groups were decreased （P〈0.05）, and the lev- els of nitric oxide （NO） and FMD were increased in two groups, compared with pre-treatment, there was significant difference （P〈0.01）. How- ever, the levels of nitric oxide （NO） and the change rate of brachial artery flow mediated dila- tation（FMD） in Group B were higher than those in Group A, there was significant difference in two groups（P〈0.05）. After treatment,the BMI was improved in patients of two groups （P 0.05, P 〈 0.01）. CONCLUSION： Pioglitazone combined with atorvastatin can adjust blood lip- ids and improve the function of vascular endo- thehum in type 2 diabetes mellitus