氟伐他汀对高胆固醇血症患者血小板活化功能及胰岛素抵抗的影响

Effects of fluvastatin on platelet activation and insulin resistance in patients with primary hypercholesterolemia

目的 探讨氟伐他汀对高胆固醇血症患者血小板功能及胰岛素抵抗的影响。方法 测定 30例高胆固醇血症或混合性高脂血症患者 (治疗组 )调脂治疗 (氟伐他汀 2 0mg/d ,治疗 4～ 8周 )前后及 30例正常对照者的血脂 ,α 颗粒膜蛋白CD6 2p(clusterofdifferentiation 6 2p ,CD6 2p) ,血糖及胰岛素水平 ,并计算胰岛素敏感性指数 (ISI)。结果 (1)治疗组及对照组治疗前的CD6 2p分别为 (5 1 6±2 3 0 1) %、(1 37± 0 5 4) % ;治疗组经氟伐他汀治疗 4周后CD6 2p降至 (2 3 6 7± 18 5 0 ) % ,较治疗前明显下降 (P <0 0 1) ;其中 18例患者继续治疗至 8周后CD6 2p降至 (2 2 0 2± 16 71) % ,但与 4周比较差异无显著性 (P >0 0 5 )。 (2 )治疗组及对照组的空腹血糖 (SG)分别为 (4 6 2± 0 5 4)mmol/L、(4 5 8±0 6 2 )mmol/L ,空腹胰岛素 (SIN)分别为 (19 84± 8 34)mmol/L、(8 14± 2 19)mmol/L(P <0 0 1) ,胰岛素敏感性指数 (ISI)分别为 1 45± 0 36、1 6 4± 0 32 (P <0 0 5 )。治疗组经氟伐他汀治疗 4周后SIN降至 (15 48± 7 6 2 )mmol/L ,较治疗前明显下降 (P <0 0 1) ;ISI升至 1 5 8± 0 43,较治疗前明显增高 (P <0 0 5 )。 (3)治疗组的血脂水平治疗后较治疗前明显降低 (P <0 0 1)。结论 ?

Objective To study the effects of fluvastatin on platelet activation and insulin resistance in patients with primary hypercholesterolemia. Methods Fasting serum lipids (TG, TC, HDL-C, LDL-C), CD62p, glucose, and insulin were measured and insulin sensitivity index (ISI) was calculated in 30 healthy subjects and 30 patients with primary hypercholesterolemia before and after 4-8 -week treatment with fluvastatin (20 mg/d). Results After fluvastatin treatment, serum TG, TC, LDL-C were lower and HDL-C was higher than before. Compared with normal subjects, (1) CD62p in patients with primary hypercholesterolemia was obviously higher (P< 0 01). After 4-week of fluvastatin treatment, CD62p decreased ( P< 0 01), but no further change after 8-week treatment in 18 patients ( P> 0 05). (2) Fasting serum glucose had no significant difference ( P > 0 05), while fasting serum insulin was higher ( P< 0 01), and insulin sensitivity index was lower ( P< 0 05). After 4-week fluvastatin treatment, fasting serum insulin was decreased ( P< 0 01), insulin sensitivity index increased ( P< 0 05). Conclusion The results suggest that lipid lowering therapy with fluvastatin has an additional effect on inhibiting the platelet activity and improving the insulin resistance.