阿托伐他汀对高脂血症患者凝血系统及胰岛素抵抗的影响

Effect of Atorvastatin on Blood Coagulation and Insulin Resistance in Hyperlipidemic Patients

目的:观察阿托伐他汀调脂同时对高脂血症患者凝血功能及胰岛素抵抗的影响。方法:选择高脂血症患者30例为血脂紊乱组,口服阿托伐他汀10mg/d,8周,检查治疗前及治疗8周后血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、空腹血糖(FSG)、空腹胰岛素(FSIN)水平并计算胰岛素敏感性指数(ISI)。另选30例血脂正常者为正常对照组。结果:与治疗前比较,血脂紊乱组治疗8周后的TC、TG、LDHC、纤维蛋白原均有显著降低(P均<0.01),HDLC显著升高(P<0.05);凝血酶时间、活化部分凝血酶时间均有显著延长(P均<0.01),凝血酶原时间显著升高(P<0.05);空腹血糖无显著变化(P>0.05),空腹胰岛素水平明显降低(P<0.01),胰岛素敏感指数明显升高(P<0.05)。与正常对照组比较,血脂紊乱组治疗8周后TC、TG、LDLC、HDLC、纤维蛋白原、凝血酶原时间、空腹血糖均接近正常对照组各指标,比较无显著差异(P>0.05)。凝血酶时间、活化部分凝血酶时间、凝血酶原时间均超出正常对照组,比较有显著差异(P<0.01～0.05)。结论:阿托伐他汀治疗高脂血症患者,在调脂的同时,可发挥其非调脂作用,可改善凝血系统及胰岛素抵抗。

Objective:To study the effect of atorvastatin on blood coagulation and insulin resistance in hyperlipidemic patients. Methods:Thirty hyperlipidemic patients received atorvastatin 10 mg/d for 8 weeks. Fasting serum lipids(TC, TG, LDL-C, HDL-C), fibrinogen(FIB), fasting serum glucose(FSG), fasting serum insulin(FSIN), fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(APTT)and prothrombin time(PT) were measured and insulin sensitivity index(ISI)was calculated in hyperlipidemic group before and after treatment. Thirty normal lipidemic subjects were assigned to control group. Results:After 8-week atorvastatin treatment , serum TC, TG, LDL-C, FIB, FSIN were significantly decreased(p<0.01) in hyperlipidemic group ; HDL-C, PT, TT, APTT and FSIN were significantly increased(p<0.05). FSG had no significant difference(p>0.05). Compared with normal lipidemic group, TC, TG, LDL-C, HDL-C, FIB, PT and FSG were not significantly different(p>0.05), while TT, APTT were significantly increaced(p<0.05). Conclusion: The results suggest that lipid lowering therapy with atorvastatin has additional benefit in improving coagulation system and insulin resistance.