阿托伐他汀对冠心病合并糖尿病患者的疗效及对血脂、血流变与凝血功能的影响

Therapeutic effect of atorvastatin on CHD + DM patients and its influence on blood lipids, hemorheology and coagulation

目的:观察阿托伐他汀治疗冠心病(CHD)合并糖尿病患者的疗效及对患者血脂、血液流变学指标与凝血功能的影响。方法:选择本院2016年2月～2017年10月间收治的112例2型糖尿病(T2DM)合并CHD的患者纳入本次研究。患者被随机均分为常规治疗组和联合治疗组(在常规治疗组基础上接受阿托伐他汀),两组均治疗3个月。观察比较两组治疗前后血糖指标、血脂、凝血功能指标、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、组织型纤溶酶原激活剂(t-PA),血流变指标:全血黏度、血浆黏度、纤维蛋白水平,以及疗效。结果:联合治疗组总有效率显著高于常规治疗组(98.21%比80.36%),P=0.002。与治疗前比较,治疗3个月后两组FPG、2hPG、HbA1c、TG、TC、LDL-C、全血黏度、血浆黏度、纤维蛋白水平显著降低,HDL-C、APTT、PT和t-PA水平显著升高(常规治疗组HDL-C、纤维蛋白水平除外),P<0.05或<0.01。与常规治疗组比较,联合治疗组治疗3个月后上述血糖指标、TC、TG、LDL-C、全血黏度[(12.19±2.67)mPa/s比(10.15±2.18)mPa/s]、血浆黏度[(2.31±0.29)mPa/s比(1.78±0.23)mPa/s]和纤维蛋白[(3.29±1.29)g/L比(2.29±0.94)g/L]水平均降低更显著,HDL-C、APTT[(29.98±2.92)s比(32.07±3.24)s]、PT[(13.89±1.63)s比(15.14±1.75)s]、t-PA [(394.62±12.76) U/L比(437.56±13.54)U/L]水平升高更显著,P<0.05或<0.01。结论:阿托伐他汀可显著降低冠心病合并糖尿病患者的血脂水平,改善血液变指标与凝血功能。

Objective: To observe therapeutic effect of atorvastatin on patients with coronary heart disease (CHD) complicated diabetes mellitus and its influence on blood lipids, hemorheological indexes and coagulation function. Methods: A total of 112 patients with type 2 diabetes mellitus (T2DM) complicated CHD, who were treated in our hospital from Feb 2016 to Oct 2017, were enrolled. Patients were randomly and equally divided into routine treatment group and combined treatment group (atorvastatin+ routine treatment group), both groups were treated for three months. Levels of blood glucose, blood lipids, coagulation function indexes: activated partial thromboplastin time (APTT), prothrombin time (PT), tissue plasminogen activator (t-PA), hemorheological indexes: whole blood viscosity, plasma viscosity, fibrin level and therapeutic effect were observed and compared between two groups before and after treatment. Results: Total effective rate of combined treatment group was significantly higher than that of routine treatment group (98.21% vs. 80.36%), P =0.002. Compared with before treatment, after three-month treatment, there were significant reductions in levels of FPG, 2hPG, HbA1c, TG, TC, LDL-C, whole blood viscosity, plasma viscosity, fibrin, and significant rise in levels of HDL-C, APTT, PT and t-PA in two groups except HDL-C and fibrin levels of routine treatment group, P <0.05 or <0.01. Compared with routine treatment after three-month treatment, there were significant reductions in levels of above blood glucose indexes, TC, TG, LDL-C, whole blood viscosity [(12.19±2.67)mPa/s vs.(10.15±2.18)mPa/s], plasma viscosity [(2.31±0.29)mPa/s vs.(1.78±0.23)mPa/s] and fibrin [(3.29±1.29)g/L vs.(2.29±0.94)g/L], and significant rise in levels of HDL-C, APTT[(29.98±2.92)s vs.(32.07±3.24)s], PT[(13.89±1.63)s vs.(15.14±1.75)s] and t-PA [(394.62±12.76) U/L vs.(437.56±13.54)U/L] in combined treatment group, P <0.05 or <0.01. Conclusion: Atorvastatin can significantly reduce blood lipid levels, contribute to improving hemorheological indexes and coagulation function in CHD + DM patients.