阿司匹林和辛伐他汀干预能缓解糖尿病患者颈动脉粥样硬化

目的探讨糖尿病患者在控制血糖的同时,辛伐他汀和肠溶阿司匹林联合用药对颈动脉粥样硬化和心、脑血管事件的干预作用。方法选择158例糖尿病合并颈动脉粥样硬化的患者,将其随机分为药物联合干预组和对照组:干预组80例,在控制血糖的同时应用辛伐他汀(每晚20 mg)和肠溶阿司匹林(每天75 mg)。对照组78例,仅给予控制血糖。共随访3年,分别在干预前及干预后第1、2、3年检测颈动脉内膜—中膜厚度、颈动脉内径、颈动脉内膜—中膜厚度与颈动脉内径的比值、颈动脉斑块积分及血糖、血脂、血小板聚集率和血浆纤维蛋白原等指标。结果干预组在随访后第1年平均颈动脉内膜—中膜厚度和斑块积分分别为1.02±0.11 mm和3.8±2.4,与干预前比较差异无显著性(P>0.05);第2年分别为0.89±0.15 mm和2.7±1.6,第3年分别为0.89±0.14 mm和2.5±1.1,这两年与干预前比较明显降低(P<0.01)。颈动脉内膜—中膜厚度与内径比值在干预后也明显降低。随访结束时,干预组心脑血管病的发生率分别为3.75%和10.00%,与对照组相比明显降低(P<0.05)。结论在有效控制血糖的同时,给予辛伐他汀和肠溶阿司匹林联合干预能延缓和逆转糖尿病患者颈动脉粥样硬化的进展,对降低心、脑血管事件的发生有很好的预防作用。

Long-term Simvastatin and Aspirin Therapy could Effectively Delay and Reverse the Progression of Carotid Arteriosclerosis in Patients with Type 2 Diabetes

Aim To investigate the intervenient efficacy of simvastatin and aspirin as well as blood sugar controlling therapy for carotid arteriosclerosis in patients with type 2 Diabetes. Methods 158 patients with type 2 diabetes and carotid arteriosclerosis were randomized into two groups.80 cases in the treatment group,were treated with both simvastatin and aspirin as well as hypoglycemia drugs;while 78 cases in the control group were treated with hypoglycemia drugs alone.Intima-media thickness(IMT) and internal diameter of Carotid arterial,the IMT and internal diameter ratio,carotid plaques score,glucose levels and the levels of serum lipids and were measured before and once a year after treatment for 3 years. Results Mean IMT of carotid artery and carotid plaques score were 1.02±0.11 mm and 3.8±2.4 respectively in the treatment group 1 year after treatment,showed no difference from that before treatment.But they were 0.89±0.15 mm and 2.7±1.6,0.89±0.14 mm and 2.5±1.1 after 2 and 3 years respectively,which were reduced significantly compared with that before treatment.The IMT and internal diameter ratio was also reduced significantly after treatment.Overall incidence of cardio-and cerebro-vascular events in the treatment group were 3.75% and 10.00% during the 3 years follow-up period,which were significantly lowed compared to the control group. Conclusions Long-term simvastatin and aspirin theraty could effectively delay and reverse the progression of carotid arteriosclerosis in patients with type 2 diabetes and prevent cardio-and cerebro-vascular events when combined with hypoglycemia drugs.