不同他汀类药物对血糖影响及机制的研究

Studies on the effects of different statins on blood glucose and its mechanism

目的探究不同他汀类药物对血糖影响及机制的研究。方法 120例非糖尿病冠心病患者,根据治疗方法不同分为甲组、乙组、丙组,各40例。甲组采用匹伐他汀进行治疗,乙组采用瑞舒伐他汀进行治疗,丙组采用阿托伐他汀进行治疗。3个月后,对比三组患者的低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素值。结果治疗前,三组患者的LDL-C、TC、HDL-C、TG比较差异无统计学意义(P>0.05)。治疗后,乙组与丙组患者的LDL-C、TC、HDL-C、TG对比差异无统计学意义(P>0.05);但甲组患者的LDL-C、TC、HDL-C、TG与乙组、丙组对比,差异具有统计学意义(P<0.05)。治疗前,三组患者的糖化血红蛋白、空腹血糖、胰岛素值、餐后2 h血糖比较差异无统计学意义(P>0.05)。治疗后,乙组与丙组患者的糖化血红蛋白、空腹血糖、胰岛素值、餐后2 h血糖对比差异无统计学意义(P>0.05);但甲组患者的糖化血红蛋白(3.89±0.70)%、空腹血糖(4.62±1.21)mmol/L、胰岛素值(27.54±24.10)m U/L、餐后2 h血糖(5.98±1.23)mmol/L,均显著低于乙组的(4.90±0.44)%、(5.22±1.89)mmol/L、(30.90±26.60)m U/L、(6.39±1.01)mmol/L和丙组的(4.32±0.51)%、(5.15±1.71)mmol/L、(30.10±25.12)m U/L、(6.22±1.22)mmol/L,差异具有统计学意义(P<0.05)。结论针对非糖尿病冠心病患者,采用匹伐他汀治疗,可加快患者康复速度,缓解临床症状,改善患者生活质量,不增加冠心病患者新发糖尿病风险,对患者糖代谢影响较小,具有临床应用价值。

Objective To explore the studies on the effects of different statins on blood glucose and its mechanism. Methods A total of 120 non diabetic patients with coronary heart disease were divided into group A, group B and group C according to different treatment methods, 40 cases in each group. Group A was treated with Pitavastatin, group B was treated with Rosuvastatin, and group C was treated with Atorvastatin. After three months, the low density lipoprotein cholesterol（LDL-C）, triglyceride（TG）, total cholesterol（TC）, high density lipoprotein cholesterol（HDL-C）, fasting blood glucose, 2-hour postprandial blood glucose, glycosylatedhemoglobin and insulin value were compared among the three groups. Results Before treatment, there were no significant differences in the LDL-C, TC, HDL-C and TG among the three groups（P〉0.05）. After treatment, there were no significant differences in LDL-C, TC, HDL-C and TG between group B and group C（P〉0.05）, but the LDL-C, TC, HDL-C, TG of group A compared with group B and group C, the differences were statistically significant（P〈0.05）. Before treatment, there were no significant differences in the glycosylated hemoglobin, fasting blood glucose, insulin value and 2 h postprandial blood glucose among the three groups（P〉0.05）. After treatment, there were no significant differences in the glycosylated hemoglobin, fasting blood glucose, insulin value and 2 h postprandial blood glucose between group B and group C（P〉0.05）, but the glycosylated hemoglobin, fasting blood glucose, insulin value and 2 h postprandial blood glucose of group A were（3.89±0.70）%,（4.62±1.21） mmol/L,（27.54±24.10） m U/L and（5.98±1.23） mmol/L respectively, which were significantly lower than（4.90±0.44）%,（5.22±1.89） mmol/L,（30.90±26.60） m U/L and（6.39±1.01） mmol/L of group B,（4.32±0.51）%,（5.15±1.71） mmol/L,（30.10±25.12） m U/L and（6.22±1.22） mmol/L of group C, the differences were statistically significant（P〈0.05）. Conclusion For non-diabetic patients with coronary heart disease, the application of Pitavastatin treatment can accelerate the rehabilitation speed of patients, alleviate clinical symptoms, improve the quality of life of patients, do not increase the risk of new onset diabetes in patients with coronary heart disease, less effect on glucose metabolism in patients, has clinical application value.