阿托伐他汀对急性冠脉综合征患者血糖代谢影响的临床研究

The Effect of Atorvastatin on Glycometabolism in Patients with Acute Coronary Syndrome

目的探讨阿托伐他汀对单纯急性冠脉综合征(ACS)患者及ACS合并糖尿病(DM)患者血糖代谢的影响。方法筛选2012年1—8月在我院急诊综合病房住院的ACS患者116例,分为ACS组(62例)和ACS+DM组(54例),入院开始口服阿托伐他汀20 mg,1次/晚,以入院时测定的血清空腹血糖(FBG)与糖化血红蛋白(HbA1c)为基线值,3个月后在我院门诊复查FBG和HbA1c,并与入院时的基线值进行比较。结果口服阿托伐他汀3个月后,ACS患者FBG水平由(5.5±0.4)mmol/L升至(5.6±0.6)mmol/L,HbA1c由(5.6±0.4)%降至(5.7±0.5)%,ACS+DM患者的FBG水平由(7.0±2.1)mmol/L降至(6.8±1.4)mmol/L,HbA1c由(7.4±1.4)%降至(7.3±1.3)%,但差异均无统计学意义(P>0.05)。结论短期常规剂量阿托伐他汀治疗可以轻微升高单纯ACS患者的血糖水平,而对于ACS+DM患者,阿托伐他汀可以轻微降低其血糖水平,其效果有待继续研究。

Objective To investigate the effect of atorvastatin on glycometabolism in patients with acute coronary syn- drome （ACS） or ACS combined with diabetes mellitus （DM）. Methods A total of 116 ACS patients admitted into Department of Emergency of our hospital between January 2012 and August 2012 were divided into an ACS group （n =62） and an ACS ＋ DM group （n = 54）. The subjects were given oral administration of atorvastatin 20 mg q. n. from admission. The levels of fast- ing blood glucose （FBG） and HbA1o were determined upon admission and in follow - up examination three months later. Results After oral administration of atorvastatin 20 mg q. n. for three months, the levels of FBG and HbA1o of patients in ACS group in- creased from （5.5± 0. 4） mmol/L to （5.6 ± 0. 6） mmol/L, from （5.6 ± 0. 4） % to （5.7 ± 0. 5 ） %, respectively; And those of patients in the ACS ＋ DM group decreased from （7. 0±2. 1 ） mmol/L to （6. 8± 1.4） mmol/L, from （7.4 ± 1.4）% to （7.3± 1.3） %, respectively. However, the changes were of no statistical significance （P 〉0. 05）. Conclusion Short - term administration of routine dose atorvastatin can elevate FBG level in patients with ACS, but reduce FBG level in patients with ACS combined with DM.