辛伐他汀对高血压并发2型糖尿病患者颈动脉粥样硬化的影响

Effect of simvastatin on carotid atherosclerosis plaque in hypertensive patients complicated with type 2 diabetes mellitus

目的:探讨辛伐他汀对高血压并发2型糖尿病(T2DM)患者颈动脉粥样硬化的影响。方法:并发T2DM的原发性高血压患者92例,随机分为2组:辛伐他汀组50例,常规治疗组42例。2组均接受常规降压、降糖、抗血小板聚集治疗,辛伐他汀组加用辛伐他汀20mg,每晚1次。分别于入院时及治疗6个月后检测血浆高敏C反应蛋白(hsCRP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C),彩色多普勒超声检测记录颈动脉内膜-中膜厚度(IMT),并计算颈动脉斑块积分。结果:常规治疗组治疗前后血浆TC、TG、LDL-C、HDL-C及hsCRP水平差异无统计学意义(P>0.05),治疗后IMT、斑块积分上升(P<0.05)。辛伐他汀组治疗后除HDL-C上升外,其余血脂指标、hsCRP、IMT及颈动脉斑块积分均较治疗前下降(P<0.01),且hsCRP与IMT及颈动脉斑块积分成正相关(r分别为0.85、0.79,P<0.05)。结论:辛伐他汀通过调节血脂、抗炎作用,改善高血压并发T2DM患者颈动脉粥样硬化程度。

Aim： To explore the effect of simvastatin on carotid atherosclerosis in hypertensive patients complicated with type 2 diabetes mellitus（T2DM）. Methods：Ninety-two hypertensive patients complicated with T2DM were randomized into two groups. One （ Group C,n = 42 ） received conventional treatment,the other （ Group S, n = 50 ） received simvastatin 20 mg/d based on the conventional treatment. Before and after 6 months treatment, hypersensitive C-reactive protein （hsCRP） , total cholesterol（ TC ） , triglyeeride （ TG ） ,low and high density lipoprotein cholesterol（ LDL-C and HDL-C ） were determined,carotid intima-medial thickness（IMT） and accumulative score of carotid plaque（AS） were measured using ultrasound. Results ：Compared with those before treatment, the levels of TC, TG, LDL-C, HDL-C and hsCRP after treatment in Group C had no change （ P 〈 0.05 ） , IMT and AS were higher（ P 〈 0.05 ） ; while in Group S, the level of HDL-C were higher, TC, TG, LDL-C, hsCRP, IMT and AS were lower after treatment（ P 〈 0.05 ） , and the level of hsCRP was positively correlated with IMT and AS （ r were 0.85, 0.79, respectively, P 〈 0. 05 ）. Conclusion ： Simvastatin improves the carotid arteriosclerosis and inflammatory reaction, promoting stabilization of atrerosclerotie plaque in hypertensive patients complicated with T2DM.