阿托伐他汀和罗格列酮对2型糖尿病并不稳定型心绞痛病人炎症因子的影响

EFFECTS OF ATORVASTATIN AND ROSIGLITAZONE ON INFLAMMATORY FACTORS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ASSOCIATED WITH UNSTABLE ANGINA

目的研究阿托伐他汀、罗格列酮对2型糖尿病(T2DM)并不稳定型心绞痛(UA)病人高敏C-反应蛋白(hs-CRP)、白细胞介素6(IL-6)、基质金属蛋白酶-9(MMP-9)水平的影响,探讨其作用机制。方法43例T2DM并UA病人随机分为两组,A组22例,给予阿托伐他汀20mg/d;B组21例,给予罗格列酮4mg/d。另取健康成年人20例作为对照组。各组分别在治疗前、治疗1个月、3个月时测定hs-CRP、IL-6、MMP-9和血脂等生化指标,并进行比较。结果A组治疗1月后MMP-9也明显下降(t=2.76,P<0.05),3个月后TC、TG、hs-CRP、IL-6、MMP-9明显下降(t=2.30～5.41,P<0.05)。B组治疗3个月时TC、hs-CRP、IL-6、MMP-9水平明显下降(t=1.75～4.23,P<0.05)。A组治疗3个月时TG较B组显著下降(t=3.17,P<0.01),TC、hs-CRP、IL-6、MMP-9两组比较无明显差异(t=0.22～1.33,P>0.05)。结论阿托伐他汀、罗格列酮单用可降低T2DM并UA病人炎症因子水平,起到纠正脂代谢紊乱、稳定斑块的作用。

Objective To investigate the effects of atorvastatin and rosiglitazone on serum levels of high sensitive c-reactive protein （hs-CRP） and interleukin 6 （IL-6） matrix metalloproteinase 9 （MMP-9） in type 2 diabetes mellitus （DM） patients with unstable angina （UA）. Methods Forty-three DM patients with UA were randomized to two groups： Group A （22 cases） received atorvastatin, 20 mg, once a day; Group B （21 cases） were given rosiglitazone, 4 mg, once a day, and 20 healthy adults were enrolled as controls. Serum levels of TC, TG, hs-CRP,IL-6,and MMP-9 were detected in each group, before and one and three months after therapy. Results In group A, the levels of MMP-9 decreased greatly after one month of treatment （t=2.76,P〈 0.05） and of TC,TG, hs-CRP, IL-6 and MMP-9 significantly lowered after three months （t=2.30-5.41 ,P〈0.05） ; In group B, at three months, TC, hs-CRP, IL-6 and MMP-9 declined obviously （t= 1. 75-4.23, P〈0.05）, but TG decreased greater in group A as opposed to group B （t= 3.17,P〈0.01）. The difference between the two groups was not significant in terms of the levels of TG, hs-CRP, IL-6 and MMP-9 （t=0.22-1.33,P〉0.05）. Conclusion Atorvastatin or rosiglitazone alone can be used to reduce inflammation factor level, correct lipid metabolic disorder and stabilize the plaque in DM patients with UA.