阿托伐他汀联合盐酸二甲双胍治疗2型糖尿病合并甲状腺功能减退症的疗效观察

Efficacy of atorvastatin combined with metformin hydrochloride in the treatment of typeⅡdiabetes mellitus with hypothyroidism

目的 观察阿托伐他汀联合盐酸二甲双胍治疗2型糖尿病合并甲状腺功能减退症的疗效。方法 抽取阳煤集团总医院2017年2月至2019年2月收治的94例2型糖尿病合并甲状腺功能减退症患者,采用随机数字表法分为观察组和对照组,每组47例,两组均予以阿托伐他汀,并配合左甲状腺素钠辅助治疗,观察组在对照组基础上加服盐酸二甲双胍。治疗16周后,比较两组患者临床疗效,治疗前、治疗16周后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)],甲状腺功能相关指标[促甲状腺素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)],以及氧化应激指标水平变化。结果 治疗16周后,观察组患者治疗总有效率高于对照组(P<0.05);两组患者FPG、2hPG、HbA1c均较治疗前降低,且观察组低于对照组(P<0.05);两组患者TSH均较治疗前降低,FT3、FT4均较治疗前升高,且两组组间TSH、FT4比较差异有统计学意义(P<0.05);两组患者活性氧(ROS)、丙二醛(MDA)水平较治疗前降低,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物(GSH-PX)水平较治疗前升高,且两组组间ROS、MDA、SOD、GSH-PX比较差异有统计学意义(P<0.05)。结论 阿托伐他汀联合盐酸二甲双胍治疗2型糖尿病合并甲状腺功能减退症疗效确切,在有效控制血糖的基础上,能改善患者甲状腺功能。

Objective To observe the efficacy of atorvastatin combined with metformin hydrochloride in the treatment of typeⅡdiabetes mellitus with hypothyroidism.Methods A total of 94 patients with typeⅡdiabetes mellitus complicated with hypothyroidism in General Hospital of Yangquan Coal Group from February 2017 to February 2019 were enrolled.The patients were divided into observation group and control group by random number table method,with 47 cases in each group.The two groups were given atorvastatin and combined with levothyroxine sodium adjuvant therapy,and observation group was additionally given metformin hydrochloride on this basis.The clinical efficacy after 16 weeks of treatment,and blood glucose indexes,including fasting plasma glucose(FPG),postprandial 2 h blood glucose(2hPG),glycosylated hemoglobin(HbA1c),thyroid function-related indicators[serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)]and oxidative stress indicators,such as reactive oxygen species(ROS),superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxide(GSH-PX),before treatment and after 16 weeks of treatment were compared between the two groups.Results After 16 weeks of treatment,the total effective rate of treatment in observation group was higher than that in control group(P<0.05).The FPG,2hPG and HbA1c in the two groups were lower than those before treatment,and the indexes in observation group were lower than those in control group(P<0.05).The TSH in the two groups was lower than that before treatment while the FT3 and FT4 were higher than those before treatment,and there were statistically significant differences in the TSH and FT4 between the two groups(P<0.05).The levels of ROS and MDA in the two groups were lower than those before treatment while the levels of SOD and GSH-PX were higher than those before treatment,and there were statistically significant differences in the ROS,MDA,SOD and GSH-PX between the two groups(P<0.05).Conclusions Atorvastatin combined with metformin hydrochloride has exact efficacy in the treatment of typeⅡdiabetes mellitus with hypothyroidism.It can improve the thyroid function of patients based on effective control of blood glucose.