不同剂量阿托伐他汀对2型糖尿病患者心血管并发症的影响

Effect of different doses of atorvastatin on cardiovascular complications in patients with type 2 diabetes

目的:观察不同剂量阿托伐他汀对2型糖尿病患者心血管并发症的影响。方法:将150例2型糖尿病患者随机分为3组,对照组50例、常规降脂组50例(阿托伐他汀20mg/d)、强化降脂组50例(阿托伐他汀40mg/d)。各组常规治疗包括抗血小板治疗和降糖(药物和/或胰岛素)治疗。均随访3年,观察各治疗组心血管并发症的发生情况,评价治疗效果。结果:与对照组相比,常规降脂组和强化降脂治疗后组TC、低密度脂蛋白-胆固醇(LDL-C)显著下降(P<0.01),高密度脂蛋白-胆固醇(HDL-C)显著升高(P<0.01)。常规降脂组与强化降脂组治疗后比较,TC、LDL-C下降程度和HDL-C升高程度比较差异有统计学意义(P<0.01)。3年内主要心血管并发症与对照组相比,强化降脂组与常规降脂组比例明显降低(P<0.05),且强化降脂组较常规降脂组心血管并发症发生比例明显降低(P<0.05)。结论:阿托伐他汀能显著减少2型糖尿病患者心血管并发症的发生,且强化降脂治疗效果更佳,无明显不良反应。

AIM： To investigate the effect of different doses of atorvastatin on cardiovascular complications in patients with type 2 diabetes. METHODS. 150 cases of type 2 diabetes patients were randomly divided into three groups, con-trol group, conventional lipidqowering group （atorvastatin 20 rag/d）, intensive lipid-lowering group 50 cases （atorvastatin 40 rag/d）（n= 50）. The conventional therapies in three groups inclu- ding antiplatelet therapy and hypoglycemic ther-apy （drugs and/or insulin）. All groups were fol-lowed up for 3 years, investigate the effect be-tween three groups in cardiovascular complica-tions. RESULTS ： Compared with control group, after treatment, the levels of TC and LDL-C were decreased and the levels of HDL-C were in-creased in conventional lipid-lowering group and intensive lipid-lowering group（P〈0.01）. After treatment, the TC, LDL-C decreased level and the HDL-C elevated level between conventional lipid-lowering group and intensive lipid-lowering group showed significantly difference （P〈0.01）. Compared with the control group, the proportion of major cardiovascular complications in 3 years was decreased significantly in the in-tensive lipid-lowering group and conventional lipid-lowering group（P〈0.05）. Compared with the conventional lipid-lowering group, the pro-portion of cardiovascular complications in the in-tensive lipid-lowering group was decreased sig-nificantly （P 〈 0.05 ）. CONCLUSION. Atorvas-tatin can decrease the cardiovascular complica-tions in patients with type 2 diabetes, the effect of intensive lipid-lowering is better, and has no adverse reaction.