瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸与高敏C反应蛋白及血脂的影响

Effects of rosuvastatin on blood homocysteine, high sensitivity C reactive protein and blood lipid in elderly patients with type 2 diabetes mellitus complicated with carotid artery plaque

目的 探讨瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸（Hcy）、高敏C反应蛋白（hs-CRP）及血脂的影响.方法 将96例老年2型糖尿病合并颈动脉斑块患者使用随机数字表法分为对照组（46例）和观察组（50例）.对照组进行常规治疗,观察组在常规治疗基础上加用瑞舒伐他汀5 mg/d,口服.比较2组患者治疗前和治疗后6周hs-CRP、Hcy、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇水平.结果 治疗后,观察组总胆固醇、LDL-C、hs-CRP、Hcy均明显低于对照组,差异均有统计学意义[总胆固醇：（4.1±l.2）mmol/L比（4.6±0.9） mmol/L,LDL-C：（2.2±0.6） mmol/L比（2.6±0.6） mmol/L,hs-CRP：（12±4）mg/L比（14±4） mg/L,Hcy：（13±4） μmol/L比（15 ±3）μmol/L]（均P＜0.05）.2组患者治疗前后肾功能、尿常规无明显变化.观察组l例患者肝功能受损,未停药,加用益肝灵口服2周后肝功能恢复.结论 瑞舒伐他汀可以降低老年2型糖尿病合并颈动脉斑块患者血脂、Hcv和hs-CRP水平.

Objective To investigate the effects of rosuvastatin on blood homocysteine （Hcy）,high-sensitivity C reactive protein （hs-CRP） and blood lipid in the elderly patients with type 2 diabetes mellitus complicated with carotid artery plaque.Methods Ninety-six senile patients with type 2 diabetes complicated with carotid artery plaque were randomly divided into control group （46 cases） receiving conventional treatment and observation group （50 cases） taking oral rosuvastatin （5 mg/d） in addition to conventional treatment.Before and 6 weeks after treatment,the levels of Hcy,hs-CRP,blood glucose,triglycerides （TG）,total cholesterol （TC）,low density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） were measured and compared between the two groups.Results The levels of blood hs-CRP,TG,TC,LDL-C,Hcy in observation group were significantly lower than those in control group [TC：（4.1 ± 1.2） mmol/L vs （4.6 ± 0.9） mmol/L,LDL-C：（2.2±0.6） mmol/L vs （2.6±0.6） mmol/L,hs-CRP：（12±4） mg/L vs （14±4） mg/L,Hcy：（13±4） μmol/L vs （15 ± 3） μmol/L] （P ＜ 0.05）.No significant changes of renal function and routine urine test were found after treatment in both the two groups.One case in observation group had impaired fiver function and recovered after taking oral silymarin for two weeks.Conclusion Rosuvastatin can decrease the levels of blood TG,TC,LDL-C,Hcy and hs-CRP in the elderly patients with type 2 diabetes mellitus complicatred with carotid plaque.