他汀类引起新发糖尿病风险的回顾性研究

A retrospective study of the risk of statin therapy inducing new-onset diabetes

目的:关注非糖尿病患者长期使用他汀类药物治疗与新发糖尿病的相关性,为临床安全合理用药提供参考。方法:采用病例回顾性研究,通过我院病历查询系统获取2003年1月-2013年4月期间在我院住院治疗过程中初次服用他汀类药物的住院患者。收集患者开始他汀类治疗后历次住院病历中的人口学资料、血糖及其他实验室检查、用药方案变化等数据,利用SPSS 19.0统计学软件进行危险因素筛选和显著性分析。结果:共纳入有效病例101例,发生新发糖尿病者6例(5.94%),男性5例(83.33%),女性1例(16.67%)。比较新发糖尿病组和未发生组的基线期情况,结果显示空腹血糖、总胆固醇和低密度脂蛋白水平在两组间有显著性差异(P<0.05)。将上述观察指标纳入Logistic回归分析,其中空腹血糖为新发糖尿病的影响因素。结论:长期服用他汀类药物可能引起新发糖尿病,对于基础空腹血糖水平较高的患者新发糖尿病风险更大。临床应用他汀类发生新发糖尿病时,应在保证他汀类疗效基础上做出对症处理。

Objective ： To assess the correlation of long-term use of statins for patients without diabetes and the incidence of new-onset diabetes, providing reference for safe and rational drug use. Methods ： In a case review study, we investigated the situation of in-patients who had begun statin therapy during 2003 to April 2013 in our hospital. Data were obtained from our medical record query system including demography, blood glucose, other la- boratory examinations and therapeutic regimens. The data were analyzed by SPSS 19.0 statistical software. Re- suits： A total of 101 patients were valid. Statin-associated new-onset diabetes occurred in 6 patients （5.94%）, in- cluding 5 males （83.33%） and 1 female （ 16.67% ）. In the patients with and without new-onset diabetes, fasten blood glucose, total cholesterol and low density lipoprotein cholesterol had statistically significant differences （P 〈 0.05）. The logistic regression analysis showed that fasten blood glucose was the effect factor of new-onset diabetes. Conclusion： Long-term use of statins may cause new-onset diabetes, especially for patients who have higher basic fasten glucose level. When new-onset diabetes occurred during statin therapy, patients should receive symptomatic treatment on the basis of assuring the effects of statins.