阿托伐他汀钙对2型糖尿病左室舒张功能不全的短期疗效

The therapeutic effect of atorvastatin on left ventricular diastolic dysfunction in type 2 diabetes mellitus in short term

目的 观察阿托伐他汀钙对2型糖尿病左室舒张功能不全的疗效,为早期防治糖尿病心脏损害提供临床依据.方法 将52例2型糖尿病左室舒张功能不全患者按随机数字表法分为对照组和他汀组,每组各26例,对照组给予常规降糖治疗,他汀组在对照组基础上加用阿托伐他汀钙10 mg/d,共治疗16周,观察两组治疗前后三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（GHbA1c）、高敏C反应蛋白（hs-CRP）水平,并利用脉冲多普勒评价治疗前后舒张早期左室充盈波（E峰）最大流速（VE）、舒张晚期左房收缩波（A峰）最大流速（VA）、VE/VA比值、E峰减速度（DC）等.结果 两组治疗后TG、TC、LDL-C、GHbA1c均较治疗前显著下降（P〈0.05）.治疗后他汀组TC、LDL-C、hs-CRP均较对照组显著下降（P〈0.05）.他汀组治疗后与治疗前比较,VE、VE/VA比值、DC显著增大（P〈0.05）,VA显著降低（P〈0.05）;与对照组治疗后比较,VE/VA比值、DC显著增大[1.390 ±1.761比0.897 ±0.089;（680 ±78）cm/s^2比（583±64）cm/s^2,P值均〈0.05].VENA比值与GHbA1c、hs-CRP呈显著负相关（t值分别为-6.232、-2.549,P值分别为0.01、0.03）.结论 阿托伐他汀钙能显著改善2型糖尿病左室舒张功能不全.他汀类药物的抗炎作用是其机制之一.

Objective To investigate the therapeutic effect and mechanism of atorvastatin on left ventricular diastolic dysfunction（LVDD）in type 2 diabetes mellitus（T2DM）.Methods Fifty-two T2DM patients with LVDD were divided randomly into statin group（26 cases）and control group（26 cases）.The statin group received atorvastatin（10 mg/d）on the basis of conventional lower blood gluconse treatment of control group,and 16 weeks were observed.The levels of triacylglyceml（TG）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,glycosyhted hemoglobin 1（GHbA1c）,high sensitive C-reactive protein（hs-CRP）were detected.The velocity of E wave（VE）,velocity of A wave（VA）,VE/VA,deceleration of E wave（DC） was determined before and after treatment by pulse Doppler.Results TG,TC,LDL-C,GHbA1c was significantly decreased after treatment in two groups（P〈0.05）.After treatment the levels of TC,LDL-C,hs-CRP in stalin group were significantly lower than those in control group（P〈0.05）.After treatment the levels of VE,VF/VA,DC were significantly increased and VA was significantly decreased in statin group（P〈0.05）.Compared with that in control group,VE/VA and DC were significantly increased in statin group after treatment[1.390±1.761 vs 0.897±0.089;（680 ±78）cm/s2 vs（583 ±64）cm/s2,P〈0.05].VE/VA level was inversely associated with GHbA1c（t=-6.232,P=0.01）and hs-CRP（t=-2.549,P=0.03）.Conclusions Atorvastatin con significandy improve LVDD in T2DM.The anti-inflammatory effect of statins is one of the mechanisms.