依折麦布在治疗糖尿病患者颈动脉粥样硬化斑块中的临床探究

Clinical Exploration of Ezetimibe on Carotid Atherosclerosis Plaques in Patients with Diabetes

目的探讨依折麦布治疗糖尿病患者颈动脉粥样硬化斑块的效果。方法选择河北省老年病医院内科2012年5月至2013年5月收治的80例糖尿病颈动脉粥样硬化斑块患者作研究对象,采用随机数字表法分为两组:对照组(40例)单用阿托伐他汀,每次20 mg,每日1次,晚上服用;观察组在对照组基础上联用依折麦布,每次10 mg,每日1次,晚上服用。两组均服用12个月。治疗前及治疗后对两组患者颈动脉内膜中层厚度、高敏C反应蛋白、斑块Crouse积分、血脂水平、颈动脉内径进行测定并比较。结果治疗后,观察组高敏C反应蛋白、低密度脂蛋白胆固醇相较疗前降低[(4.38±1.24)mg/L vs(7.07±2.59)mg/L;(2.12±0.46)mmol/L vs(3.18±0.45)mmol/L,P<0.05],治疗后观察组颈动脉内膜中层厚度、斑块Crouse积分对比治疗前好转[(1.02±0.11)mm vs(1.27±0.22)mm;(3.81±1.23)分vs(4.29±1.62)分P<0.05]。治疗后观察组颈动脉内膜中层厚度、斑块Crouse积分改善优于对照组(P<0.05)。结论糖尿病患者颈动脉粥样硬化斑块在他汀类药物的基础上应用依折麦布治疗,可显著改善临床症状,提高临床治疗效果,保障患者生存质量。

Objective To investigate the effect of ezetimibe on carotid atheroselerosis plaque in patients with diabetes. Methods A total of 80 diabetic patients with carotid atherosclerotic plaque from Department of Internal Medicine, Hebei Provincial Geriatric Hospital from May 2012 to May 2013 were included as study objects,were randomly divided into observation group and control group ,40 cases in each group：the control group was treated with atorvastatin 20 rag/time, 1 time/day, night use, for 12 months; the treatment group was added with ezetimibe 10 mg/time,1 tlme/day,night use,for 12 months. The carotid artery intima media thickness,high sensitive C reactive protein,plaque Creuse integral,blood lipid level,diameter of carotid artery were detected before and after the treatment were tested and compared. Results The high sensitive C reactive protein,low density lipoprotein cholesterol of the observation group dropped from before treatment[（4.38±1.24 ） mg/L vs （7.07±2.59） mg/L, （2.12±0.46） mmol/L vs （3.18±0.45） mmol/L,P 〈0.05] ,after treatment,the carotid intima-media thickness, plaque Crouse integral of the observation group were better than before treatment [ （ 1.02±0.11 ） mm vs （ 1.27±0.22） ram, （3.81±1.23 ） vs （4.29 ±1.62）, P 〈 0.05 ]. After treatment, the carotid intima-media thickness, plaque integral Crouse of the observation group were better than the control group （ P 〈 0.05）. Conclusion Treatment of carotid atherosclerosis plaques in diabetic patients with ezetimibe on the basis of statins treatment, can significantly improve the clinical symptoms, improve the clinical therapeutic effect, and better the quality of life of the patients.