普伐他汀改善2型糖尿病合并高血压患者颈动脉粥样硬化研究

Study on pravastatin for improving carotid atherosclerosis in patients type 2 diabetes mellitus complicating hypertension

目的探讨普伐他汀对2型糖尿病合并高血压患者颈动脉粥样硬化的影响。方法选取2015年4月至2016年4月该院收治的2型糖尿病合并高血压患者106例,将其分为常规治疗组(52例)和普伐他汀组(54例);常规治疗组患者给予控制饮食、降血糖、控制血压及对症支持治疗等常规治疗,普伐他汀组患者在常规治疗的基础上加用普伐他汀;治疗前后应用高频超声检测技术检测颈动脉内膜中层厚度(IMT),记录斑块检出率、颈动脉斑块积分的变化,同时检测血清血脂和高敏C反应蛋白(hsCRP)的变化。结果常规治疗组患者上述各项指标在治疗前后比较,差异无统计学意义(P>0.05);普伐他汀组患者治疗后IMT值、斑块积分、斑块检出率均较治疗前降低,血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇及hs-CRP水平亦较治疗前降低,差异均有统计学意义(P<0.05),并且治疗后普伐他汀组上述各项指标均明显低于常规治疗组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论普伐他汀可以有效而安全地改善2型糖尿病合并高血压患者颈动脉粥样硬化程度。

Objective To explore the effect of pravastatin on carotid atherosclerosis in the patients with type 2 diabetes mellitus （T2DM） complicating hypertension. Methods One hundred and six patients with T2DM complicating hypertension treated in this hospital from April 2015 to April 2016 were selected and divided into the conventional treatment group （n= 52） and pravastatin group （n= 54）. The patients of conventional treatment group were given the conventional therapy of diet control, reducing blood glucose,controlling hypertension, symptomatic and support treatment, while on the basis of conventional therapy the patients of pravastatin group were added with pravastatin. The carotid intima-medial thickness （IMT） ,detection rate of carotid atherosclerotic plaque and carotid plaque score were measured by ultrasound before and after the treatment in all cases. Meanwhile the levels of serum lipid and hyper sensitive C reactive protein （hs-CRP） were determined. Results The above indicators in the conventional treat ment group had no statistically significant difference between before and after treatment （P〉0. 05）, but the IMT value, detection rate of carotid atherosclerotic plaque and carotid plaque score after treatment in the pravastatin group were decreased compared with before treatment, the levels of serum total cholesterol （TC）, triaeylglycerol （TG） ,low density lipoprotein cholesterol （LDL-C） and hs-CRP were alsO significantly reduced compared with before treatment, the differences were statistically significant （P〈 0.05）, moreover the above indicators after treatment in the pravastatin group were remarkably lower than those in the conventional treatment group （P〈0.05）. There was no statistically significant difference in the incidence rate of adverse reactions between the two groups （P〉0. 05）. Conclusion Pravastatin can effectively and safely improve the carotid atherosclerosis degree in the patients with T2DM complicating hypertension.