阿托伐他汀与非诺贝特治疗高脂血症伴胰岛素抵抗疗效比较

Comparison of the Efficacy of Atorvastatin vs Fenofibrate for the Treatment of Hyperlipidemia with Insulin Resistance

【目的】比较阿托伐他汀与非诺贝特治疗高脂血症伴胰岛素抵抗的疗效。【方法178例高脂血症伴胰岛素抵抗患者随机分成两组，分别给予阿托伐他汀和非诺贝特，疗程为12周。比j较两组治疗前后血清总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）、空腹胰岛素（FINs）、肝功能、肾功能、肌酸激酶（CK）及胰岛素抵抗指数（HOMA-IR）的变化。【结果】两组治疗后均能降低TG、LDL—C并能升高HDL-C（P〈o．01），非诺贝特降低TG水平较阿托伐他汀更显著（P〈o．05），阿托伐他汀较非诺贝特降低TC、LDL—C及升高HDL—C更显著（P〈0．05），并能降低FINS及HOMA—IR（P〈0．05）。二者在FBG、肝功能、肾功能、CK的比较无统计学意义（P〉0．05）。【结论】阿托伐他汀比非诺贝特具有更好的调脂作用，并能改善胰岛素抵抗。

[Objective]To compare the efficacy of atorvastatin vs fenofibrate for the treatment of hyperlipi- demia with insulin resistance. [Methods] Totally 78 patients with hyperlipidemia and insulin resistance were randomly divided into two groups which were given atorvastatin and fenofibrate for 12 weeks, respectively. Total cholesterol（TC）, triglyceride（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipopro- tein cholesterol（LDL-C）, fasting blood glucose（FBG）, fasting insulin（FINS）, liver function, kidney function, creatine kinase（CK） and homeostasis modal assessment insulin resistance（HOMA-IR） were compared before and after treatment. [Results] After treatment, TG and LDL-C of two groups decreased and HDL-C increased （ P 〈0.01）. Fenofibrate reduced TG level more significantly than atorvastatin（ P 〈0.05）. Atorvastatin re- duced the levels of TC and LDL-C and increased HDL-C more significantly than fenofibrate（ P 〈0.05）, and reduced FINS and HOMA-IR（ P 〈0.05）. There was no significant difference in FBG, liver function, kidney function and CK between two groups （ P 〈0.05）. [Conclusion] Atorvastatin has a better lipid-regulating effect than fenofibrate, and can improve insulin resistance.