阿托伐他汀和瑞舒伐他汀对非糖尿病脑梗死二级预防患者血糖的影响

Effects of atorvastatin and rosuvastatin on blood glucose in patients with non-diabetes but with cerebral infarction secondary prevention

目的观察非糖尿病脑梗死二级预防患者服用不同剂量阿托伐他汀和瑞舒伐他汀调控血脂时血糖相关指标的变化。方法将150例患者随机分为5组各30例,分别给予阿托伐他汀钙片10mg、20mg、40mg和瑞舒伐他汀钙片10mg、20mg,口服,每晚1次。疗程均为24周。观察治疗前后空腹三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)的变化。结果治疗后,阿托伐他汀10mg组、20mg组、40mg组和瑞舒伐他汀10mg组、20mg组TG、TC、LDL-C较治疗前明显下降,阿托伐他汀20mg组HbA1c较治疗前升高,阿托伐他汀40mg组FBG和HbA1c较治疗前升高(P<0.05);治疗后,阿托伐他汀20mg组、40mg组和瑞舒伐他汀10mg组、20mg组TG、TC、LDL-C低于阿托伐他汀10mg组,阿托伐他汀40mg组TG、TC、LDL-C又低于20mg组和瑞舒伐他汀10mg组,瑞舒伐他汀20mg组低于10mg组(P<0.05),阿托伐他汀40mg组HbA1c高于阿托伐他汀10mg组、20mg组和瑞舒伐他汀10mg组、20mg组(P<0.05)。结论瑞舒伐他汀降脂效果与阿托伐他汀相同时对FBG和HbA1c影响较小。

Objective To observe the level changes of blood glucose related indexes in patients with non-diabetes but with cerebral infarction secondary prevention,when they took different doses of atorvastatin or rosuvastatin to regulate blood lipids.Methods One hundred and fifty patients were randomly divided into5groups,30patients in each group.They were respectively treated with10mg atorvastatin,20mg atorvastatin,40mg atorvastatin,10mg rosuvastatin or20mg rosuvastatin by oral administration once a night.The course of treatment was24weeks.The level changes of fasting triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)in those patients were observed before and after treatment.Results After treatment,the level of TG,TC and LDL-C of each group were significantly decreased,HbA1c level of20mg atorvastatin group was significantly increased and the level of FBG and HbA1c of40mg atorvastatin group were significantly increased(P<0.05).Pairwise comparison among groups after treatment:the level of TG,TC and LDL-C of10mg atorvastatin group were significantly higher than those of other four groups,those of40mg atorvastatin group were significantly lower than those of20mg atorvastatin group and two rosuvastatin groups.Those of20mg rosuvastatin group were significantly lower than those of10mg rosuvastatin group(P<0.05).HbA1c level of40mg atorvastatin group were significantly higher than that of other four groups(P<0.05).Conclusion The effect of rosuvastatin on FBG and HbA1c is less than that of atorvastatin when the lipid-lowering effect of rosuvastatin is the same as that of atorvastatin.