普伐他汀和美托洛尔对冠心病患者血清脂联素及相关指标的影响

Effect of Pravastatin and Metoprolol on serum adiponectin and correlated indicatrixes in patients with coronary heart disease

目的研究冠心病患者应用普伐他汀和美托洛尔后血清脂联素及相关指标的变化。方法冠心病患者112例,分为:常规用药组28例;普伐他汀组25例;美托洛尔组32例;普伐他汀及美托洛尔联合组;27例。测定空腹血糖(FPG)、胰岛素(FINS)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和血清脂联素(APN)水平,并计算胰岛素敏感性指数(ISI)。2月后复查上述生化指标。结果普伐他汀组用药后APN,ISI升高(P<0.05),FINS,TC,TG,LDL-C降低(P<0.05,P<0.01,P<0.05,P<0.05);美托洛尔组用药后APN,TC升高(P<0.05),ISI降低(P<0.05);联合用药组用药后APN,ISI,HDL-C升高(P<0.01,P<0.05,P<0.05),FINS,TC,TG,LDL-C降低(P<0.05,P<0.01,P<0.01,P<0.05)。联合用药组与普伐他汀组、美托洛尔组比较,APN,HDL-C升高更显著(P<0.05),TG,LDL-C降低更显著(P<0.05);与美托洛尔组比较,TC降低更显著(P<0.01),ISI升高更显著(P<0.01);与普伐他汀组比较,TC,ISI差异无显著性。结论普伐他汀和美托洛尔可以提高冠心病患者血清APN水平,降低冠心病危险因素,联合应用于冠心病患者在改善胰岛素敏感性、调脂及提高血清APN水平方面,优于单独用药。

AIM To investigate the transmutation of serum adiponectin and correlated indicatrixes in patients with coronary heart disease after using Pravastatin and Metoprolol. METHODS One hundred and twelve cases with coronary heart disease were divided into conventional therapy group （28 cases ）, Pravastatin group （25 cases ）, Metoprolol group （32 cases ）, and the combination group using both Pravastatin and Metoprolol （27cases）. Fasting plasma glucose （FPG） , insulin （FINS） , total cholesterol （TC） , triglyceride （TG） , low density lipoprotein cholesterol （LDL-C） , high density lipoprotein cholesterol （HDL-C） and the level of serum adiponectin （APN） were measured and insulin sensitivity index （ISI） was calculated. These biochemical indicators above-mentioned were reexamined after two months. RESULTS After the treatment, Pravastatin group had higher levels of serum adiponectin and ISI （ P 〈 0.05 ） and lower levels of FINS, TC, TG and LDL-C （ P 〈 0.05, P 〈 0.01, P 〈 0.05, P 〈 0.05 ） , Metoprolol group had higher levels of APN and TC （ P 〈 0. 05 ） and lower levels of ISI （ P 〈 0.05 ） and combination group had higher levels of APN, ISI and HDL-C（P 〈0.01, P 〈0.05, P 〈0.05） and lower levels of FINS, TC, TG and LDL-C （P 〈 0.05, P 〈 0.01, P 〈 0.01, P 〈 0.05 ）. The combination group had obviously higher levels of APN and HDL-C （ P 〈 0.05 ） and lower levels of TG and LDL-C （ P 〈 0.05 ） than those in Pravastatin group and Metoprolol group. The combination group had obviously lower levels of TC（P 〈0.01 ）and higher levels of ISI（P 〈0.01 ）than those in Metoprolol group. The combination group had no significant difference in the levels of TC and ISI compared with those in Pravastatin group. CONCLUSION Pravastatin and Metoprolol can raise the levels of serum adiponectin in patients with coronary heart disease and cut down the risk factors in coronary heart disease. Combined use of both them is better than the use of one of them alone in improving insulin sensitivity, adjusting serum lipid and increasing the level of serum APN level.