1例冠心病伴2型糖尿病患者服用阿托伐他汀钙引发的思考

One case of coronary artery disease and type 2 diabetes patients taking atorvastatin calcium thinking triggered

通过考察1例冠心病伴2型糖尿病患者服用他汀类药物治疗效果,研究阿托伐他汀在糖尿病患者中使用的合理性。患者入院时饭后血糖高达14.76 mmol/L,血糖监控表显示患者在22日中餐前,23日早餐、中餐前血糖均>7 mmol/L,患者空腹血糖控制不佳,23日临床药师与医生查房建议患者加大甘精胰岛素用量,晚上皮下注射甘精胰岛素加至20 U,24日晚餐前后血糖仍>7 mmol/L,血糖控制不佳。由此可知,本例患者应用他汀药物可能会导致患者血糖异常,但相对心血管不良风险,本例使用阿托伐他汀是合理的。

The purpose of this experiment is by examining one case of coronary heart disease in patients with type 2 diabetes patients taking statin therapy to study the effect of atorvastatin use in diabetic patients is reasonable.Admission of patients up to 14.76 mmol/L postprandial glucose,blood glucose monitoring in the table shows that patients 22 fast-ing,before breakfast on the 23rd,the fasting blood glucose were 〉 7 mmol/L,fasting blood glucose control in patients with poor clinical pharmacists and physicians on the 23rd rounds advise patients to increase the amount of insulin glargine night subcutaneous insulin glargine was added to 20 U,blood sugar before and after dinner on the 24th is still greater than 7 mmol/L,poor glycemic control.It can be seen that the patients using statins may cause abnormal blood sugar,but with respect to adverse cardiovascular risk,in this case the use of atorvastatin is reasonable.