匹伐他汀及阿托伐他汀对老年2型糖尿病患者血脂、血糖的影响

Effects of pitavastatin and atorvastatin on blood lipids and blood glucose in elderly type 2 diabetic patients

目的比较老年2型糖尿病患者服用匹伐他汀或阿托伐他汀后血脂、血糖的变化。方法 80例血糖控制良好的2型糖尿病住院患者,半随机分为阿托伐他汀组和匹伐他汀组,均n=40,分别每日口服阿托伐他汀20 mg或匹伐他汀2 mg,治疗3 mo,比较2组血脂和血糖变化。结果治疗3 mo后,匹伐他汀组及阿托伐他汀组对总胆固醇、三酰甘油和低密度脂蛋白胆固醇无显著差异(P>0.05),但匹伐他汀组较阿托伐他汀组升高高密度脂蛋白胆固醇和降低空腹血糖作用更显著(P<0.05),2组糖化血红蛋白均无显著改变(P>0.05),但均可显著减少患者血糖波动(P<0.05);2组患者不良反应发生率无显著差异(P>0.05)。结论匹伐他汀2 mg可升高高密度脂蛋白胆固醇,降低患者空腹血糖水平并减少血糖波动,作用优于阿托伐他汀20 mg。

AIM To compare the changes of blood lipids and blood glucose after pitavastatin or atorvastatin treatment in elderly type 2 diabetic patients. METHODS Eighty elderly patients with type 2 diabetes were divided into atorvastatin （20 mg, n = 40） group and pitavastatin （2 mg, n = 40） group once daily for 3 months using a quasi-randomization approach, who were in a good blood glucose level and were into two groups. Blood lipids and blood glucose were measured before and after the treatment. RESULTS After 3 months, the decrease in total cholesterol, triglycerides and low density lipoprotein cholesterol had no significant difference between the two groups （P 〉 0.05）. But the pitavastatin group had better effects on raising high density lipoprotein Cholesterol and decreasing fasting blood glucose than the atorvastatin group （P 〈 0.05）. The change in glycosylated hemoglobin had no significant difference between the two groups （P 〉 0.05）. Pitavastatin had little influence on glucose metabolism which suggested minimal blood glucose fluctuations in patients （P 〈 0.05）. The side effects in both treatments had no significant difference （P 〉 0.05）. CONCLUSION Pitavastatin can increase density lipoprotein cholesterol and reduce levels of fasting blood glucose and blood glucose fluctuations, which is superior to atorvastatin.