依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床效果

Effect of ezetimibe combined with rosuvastatin in treating type 2 diabetes mellitus complicated with hyperlipidemia

目的探讨依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床疗效。方法选取2013年6月至2014年6月于解放军总医院接受治疗的2型糖尿病合并高脂血症患者140例，根据随机数字表法分成观察组和对照组，各70例。对照组在常规治疗的基础上给予瑞舒伐他汀10mg，1次／d口服。观察组在常规治疗的基础上分别给予瑞舒伐他汀10mg和依折麦布10mg，1次／d口服。2组均治疗3个月。治疗前和治疗3个月后，检测并比较2组空腹胰岛素、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL—C）水平，并记录LDL．C〈4．14mmol／L及〈3．37mmol／L的患者比例以及不良反应发生情况。结果治疗前，观察组与对照组患者空腹胰岛素、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、LDL-C、HDL—C水平和LDL—C〈4．14mmol／L及〈3．37mmol／L的患者比例比较，差异均无统计学意义（均P〉0．05）。治疗后，2组总胆固醇、三酰甘油、LDL—C水平明显低于治疗前，且观察组低于对照组[（3．5±0．7）mmol／L比（4．2±0．6）mmol／L、（1．28±0．12）mmol／L比（1．49±0．14）mmol／L、（3．2±0．6）mmo]／L比（4．0±0．8）mmol／L]，差异均有统计学意义（均P〈0．05）。2组治疗后LDL—C〈4．14mmol／L及〈3．37mmol／L的患者比例均高于治疗前，且观察组高于对照组[62．9％（44／70）比28．6％（20／70）、90．0％（63／70）比67．1％（47／70）]，差异均有统计学意义（均P〈0．05）。2组治疗前后丙氨酸转氨酶、天冬氨酸转氨酶、肌酸激酶水平以及治疗后胃肠道反应发生情况比较，差异均无统计学意义（均P〉0．05）。结论依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床疗效优于单纯使用瑞舒伐他汀治疗。

Objective To explore the effect of ezetimibe combined with rosuvastatin in treating type 2 diabetes mellitus complicated with hyperlipidemia. Methods Totally 140 cases with type 2 diabetes mellitus complicated with hyperlipidemia from June 2013 to June 2014 were randomly divided into observation group and control group （70 cases in each group）. Both groups received conventional treatment; control group was added rosuvastatin （10 mg, 1 time/d, orally）; observation group was added rosuvastatin （10 mg, 1 time/d, orally） and ezetimibe （10 mg, 1 time/d, orally）. The treatment lasted for 3 months. The levels of fasting insulin, fasting glucose, glycosylated hemoglobin, triacylglyeerol, total cholesterol, low density lipoprotein cholesterol （LDL-C） , high density lipoprotein cholesterol （HDL-C） before and after treatment. The ratios of cases with LDL-C 〈 4. 14 mmoL/L and 〈 3.37 mmol/L and the incidence of adverse reactions were recorded. Results The levels of fasting insulin, fasting glucose, glycosylated hemoglobin, total cholesterol, triaeylglycerol, LDL-C, HDL-C, ratios of cases with LDL-C 〈4. 14 mmol/L and 〈 3.37 mmol/L before treatment were not significantly different between groups （P 〉 0. 05 ）. After treatment, the levels of total cholesterol, triacylglycerol, LDL-C were significantly decreased in both groups, and were significantly lower in observation group than those in control group [ （3.5±0. 7） mmo//L vs （4. 2 ±0. 6） nmao//L, （1.28 ±0. 12） mmol/L vs （1.49 ±0. 14） mmol/L, （3. 2 ±0. 6） mmo//L vs （4. 0 ±0. 8） mmol/L~ , the ratios of eases with LDL-C 〈4. 14 mmol/L and 〈 3] 37 mmol/L were significantly increased, and were significantly higher in observation than those in control group E 62. 9% （44/70） vs 28.6% （20/70）, 90. 0% （63/70） vs 67.1% （47/70） （P 〈0.05）. The levels of alanine aminotransferase, aspartate aminotransferase, creatine kinase and ineidenee of gastrointestinal reaction before and after treatment were not significantly different between groups （P 〉 0.05 ）. Conclusion Ezetimibe combined with rosuvastatin has better effect compared with single rosuvastatin in treating type 2 diabetes mellitus complicated with hyperlipidemia