瑞舒伐他汀钙片联合盐酸吡格列酮片对Ⅱ型糖尿病患者血脂及颈动脉粥样硬化的影响

Effects of Pioglitazone and Rosuvastatin Combination Therapy on Serum Lipid and Carotid Atherosclerosis in Type 2 Diabetes

目的观察瑞舒伐他汀钙片联合盐酸吡格列酮片对Ⅱ型糖尿病患者血脂及颈动脉粥样硬化的影响.方法96例Ⅱ型糖尿病患者随机分成对照组与治疗组,对照组单独服用瑞舒伐他汀钙片,治疗组同时服用瑞舒伐他汀钙片与盐酸吡格列酮片.治疗20个月后观察患者空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、颈动脉内中膜厚度(IMT)及颈动脉斑块Crouse积分等变化.结果治疗前后各组组内比较,对照组TC及LDL明显下降,具有统计学意义(P<0.01);IMT、颈动脉斑块Crouse积分下降,具有统计学意义(P<0.05);HDL呈升高趋势,但无统计学意义(P>0.05).治疗组TC,LDL,TG及FPG明显下降,具有统计学意义(P<0.01);IMT、颈动脉斑块Crouse积分均下降,具有统计学意义(P<0.05);HDL升高,具有统计学意义(P<0.05).治疗后各组组间比较HDL明显升高,具有统计学意义(P<0.01);FPG,TG,IMT,颈动脉斑块Crouse积分下降,具有统计学意义(P<0.05).结论与单独应用瑞舒伐他汀钙片比较,联合应用瑞舒伐他汀钙片与盐酸吡格列酮片能进一步降低TG,IMT及颈动脉斑块Crouse积分,显著升高HDL.

Objective To investigate the effects of pioglitazone and rosuvastatin combination therapy on serum lipid and carotid atherosclerosis in type 2 diabetes,and to explore the relationship between serum lipid and atherosclerosis.Method Ninety-six cases of type 2 diabetes patients were randomly divided into two groups：control group and treatment group.The control group was given rosuvastatin,and the treatment group was given rosuvastatin and pioglitazone.At the baseline and the end of the treatment,carotid intimal-medial（IMT）thickness and integral for carotid plaque Crouse were detected by ultrasound,simultaneously,the levels of fasting plasma glucose（FPG）,triglycerides（TG）,total cholesterol（TC）,low density lipoprotein（LDL） and high density lipoprotein（HDL） were also determined.Results Comparison within each group before and after treatment,in therosuvastatin group,both TC and LDL decreased obviously with significant differences（P0.0 1）,the carotid intima-media thickness and carotid plaque Crouse score decreased with statistical differences（P〈0.05）,HDL showed ascendant trend without significance.In the therapy group,all the levels of TC,LDL,TG and FPG decreased obviously with significant differences（P〈0.01）,the carotid intima-media thickness and carotid plaque Crouse score decreased with statistical differences（P〈0.05）,and HDL rised with statistical differences（P〈0.05）.Compared with the control group,the level of HDL increased obviously with statistical differences（P〈0.01） in the treatment group.The levels of FPG and TG,carotid intima-media thickness and carotid plaque Crouse score decreased significantly（P〈0.05）.Conclusion Compared with rosuvastatin alone,rosuvastatin and pioglitazone combination therapy in patients with type 2 diabetes can significantly increase HDL level,further lower TG and decrease carotid intima-media thickness and carotid plaque Crouse score.