辛伐他汀对陈旧性心肌梗死伴高脂血症患者胰岛素抵抗的影响

Efects of simvastatin on insulin resistance in patients with old myocardial infarction

目的:观察陈旧性心肌梗死(OMI)伴高脂血症患者胰岛素抵抗(IR)状态及辛伐他汀对其影响。方法:48例OMI伴高脂血症患者随机分为常规治疗组(R组)24例和常规+辛伐他汀治疗组(S组)24例。比较二组治疗前后血脂水平(TC、TG、LDL-C、HDL-C)、空腹血糖(FPG)、胰岛素抵抗(HOMA-IR)和胰岛素敏感指数(ISI)的变化,并与24例健康对照组(C组)比较。结果:与对照组相比,OMI伴高脂血症患者TC、TG、LDL-C升高,HDL-C降低(P<0.05);CHD组FPG有上升趋势(P>0.05),FINS增高,ISI下降,IR增高(均P<0.01),ISI降低,HOMA-IR增加(P<0.001);R组和S组患者治疗后ISI升高,而HOMA-IR降低,S组治疗后ISI增高和HOMA-IR降低的程度明显优于R组(P<0.05)。结论:OMI伴高脂血症患者存在IR,辛伐他汀可提高其胰岛素敏感性。

Objective： To observe old myocardial infarction（OMI） patients with hyperlipidemia in insulin resistance（IR） state and effects of simvastatin.Methods：48 OMI cases with hyperlipidemia were randomly divided into conventional treatment group（R group,24 cases） and conventional treatment with simvastatin group（S group,24 cases）.Compare the changes of two groups before and after treatment lipid（TC,TG,LDL-C,HDL-C）,fasting plasma glucose（FPG）,fasting insulin（FINS）,insulin resistance（HOMA-IR） and insulin sensitivity index（ISI）.Also healthy control group（C group,24 cases） were compared.Results：Compared with the control group,the TC,TG,LDL-C of OMI patients with hyperlipidemia increased,and HDL-C reduced（P〈0.05）;the FPG of CHD group has upward trend（P〉0.05）,FINS,IR increased（P〈0.01） ISI reduced and HOMA-IR increased（P〈0.001）;after treatment,the ISI of R group and group S patients increased while HOMA-IR reduced,and S group was significantly better than the R group（P〈0.05）.ConclusionThe existence of insulin resistance state in OMI patients with hyperlipidemia is a fast,but simvastatin can improve their insulin sensitivity.