阿昔莫司联合二甲双胍和瑞舒伐他汀治疗高脂血症合并2型糖尿病的疗效观察

Efficacy Observation of Axilimus with Metformin and Rosuvastatin in the Treatment of Hyperlipidemia with Type 2 Diabetes

目的:探究阿昔莫司联合二甲双胍和瑞舒伐他汀对高脂血症合并2型糖尿病患者血脂水平、血糖水平及血液流变学的影响。方法:选取本院2019年4月~2020年5月收治的高脂血症合并2型糖尿病患者90例,采用随机数字表法分为观察组和对照组,每组45例。对照组给予二甲双胍和瑞舒伐他汀治疗,观察组在对照组的基础上给予阿昔莫司治疗。比较两组治疗前后血脂水平[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血糖水平及胰岛素抵抗[餐后2h血糖、空腹血糖、胰岛素抵抗指数(HOMA-IR)]、生化指标[肌酸激酶(CK)、谷丙转氨酶(GPT)、髓过氧化物酶(MPO)、丙二醛(MDA)]、血液流变学(全血黏度、血浆黏度、血浆纤维蛋白原)变化以及不良反应发生率。结果:与治疗前相比,两组治疗后TG、TC、LDL-C、餐后2h血糖、空腹血糖、HOMA-IR、CK、GPT、MPO、MDA、全血黏度、血浆黏度、血浆纤维蛋白原水平均降低(P<0.05),且观察组低于对照组(P<0.05);与治疗前相比,两组HDL-C水平均升高(P<0.05),且观察组高于对照组(P<0.05);观察组不良反应发生率(6.67%)低于对照组(24.44%,P<0.05)。结论:阿昔莫司联合二甲双胍和瑞舒伐他汀治疗高脂血症合并2型糖尿病效果较好,可有效改善患者血脂水平,调节生化指标及血液流变学变化,降低血糖水平、胰岛素抵抗以及不良反应发生率。

Objective: To investigate the effects of acipimox with metformin and rosuvastatin on blood lipid,blood glucose level and hemorheology in patients with hyperlipidemia and type 2 diabetes. Methods: A total of 90 patients with hyperlipidemia and type 2 diabetes admitted in our hospital from April 2019 to May 2020 were selected as subjects and divided into the observation group and the control group according to the random number table, 45 cases in each group. The control group was treated with metformin and rosuvastatin,and the observation group was treated with acipimox on the basis of the control group. The levels of blood lipids [total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C) ], blood glucose level and insulin resistance [2 h postprandial blood glucose,fasting blood glucose, insulin resistance index(HOMA-IR) ], biochemical indexes [creatine phosphokinase(CK), glutamic-pyruvic transaminase(GPT), myeloperoxidase(MPO), malondialdehyde(MDA) ],hemorheological changes(whole blood viscosity, plasma viscosity, plasma fibrinogen) before and after treatment and the incidence of adverse reactions were compared between the two groups. Results: Compared with those before treatment, TG, TC, LDL-C, 2h postprandial blood glucose, fasting blood glucose, HOMAIR, CK, GPT, MPO, MDA, whole blood viscosity, plasma viscosity, and plasma fibrinogen levels all decreased in the two groups after treatment(P<0.05), and the observation group significantly decreased compared with the control group(P<0.05). Compared with those before treatment, the HDL-C levels in the two groups were significantly increased(P<0.05);and the HDL-C levels in the observation group increased compared with those in the control group(P<0.05). The incidence of adverse reactions in the observation group(6.67%) was significantly lower than that in the control group(24.44%, P<0.05). Conclusion: Acipimox with metformin and rosuvastatin is effective in the treatment of hyperlipidemia with type 2 diabetes. It can effectively improve the blood lipid level, regulate the biochemical indexes and hemorheology changes, and reduce the blood glucose level, insulin resistance and the incidence of adverse reactions.