小剂量瑞舒伐他汀联合甘精胰岛素治疗2型糖尿病合并血管并发症患者的疗效及其对血管内皮功能的影响

Effect of Low-dose Rosuvastatin combined with Insulin Glargine on vascular endothelial Function in Type 2 Diabetes Patients with vascular Complications

目的 探讨小剂量瑞舒伐他汀联合甘精胰岛素治疗2型糖尿病合并血管并发症患者的疗效及其对血管内皮功能的影响。方法 本研究选取2020年8月至2022年8月郑州颐和医院收治的82例2型糖尿病合并血管并发症患者按随机数字表法分组;其中单纯给予甘精胰岛素治疗的41例为基础组,在接受甘精胰岛素治疗的同时配合使用瑞舒伐他汀(小剂量)的41例患者为联合组。比较两组血糖指标、颈动脉斑块状况、血脂指标、疗效及血管内皮功能。结果 两组患者疗程结束时空腹血糖(FPG)、餐后2 h血糖(2hPBG)及糖化血红蛋白(HbA1c)均低于入院第2 d,且联合组低于基础组,差异有统计学意义(P<0.05)。两组患者疗程结束时颈动脉内膜-中层厚度(IMT)、斑块面积及斑块数量均低于入院第2 d,且联合组低于基础组,差异有统计学意义(P<0.05)。两组患者疗程结束时低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)水平均低于入院第2 d,其高密度脂蛋白胆固醇(HDL-C)显著高于入院第2 d;联合组血脂各项指标改善幅度均大于基础组,差异有统计学意义(P<0.05)。联合组治疗有效率(95.12%)高于基础组(80.49%),差异有统计学意义(P<0.05)。两组患者疗程结束时内皮素-1(ET-1)及血管内皮生长因子(VEGF)水平均低于入院第2 d,其一氧化氮(NO)含量显著高于入院第2 d,且联合组血管内皮指标改善幅度均大于基础组,差异有统计学意义(P<0.05)。结论 在甘精胰岛素的基础上应用瑞舒伐他汀,可显著改善2型糖尿病合并血管并发症患者的血管内皮功能,疗效确切。

Objective To investigate the efficacy of low dose rosuvastatin combined with insulin glargine in the treatment of type 2 diabetes patients with vascular complications and its effect on vascular endothelial function.Methods From August 2020 to August 2022,82 patients with type 2 diabetes complicated with vascular complications admitted to Zhengzhou Yihe Hospital were divided into two groups according to the random number table;Among them,41 patients who received insulin glargine alone as the base group,and 41 patients who received insulin glargine treatment with rosuvastatin(low dose)as the combined group.The blood glucose index,carotid plaque status,blood lipid index,therapeutic effect,and vascular endothelial function between the two groups were compared.Results The fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPBG),and glycosylated hemoglobin(HbA1c)in the two groups at the end of the treatment period were lower than those on the second day of admission,and the combined group was lower than the base group,with a statistically significant difference(P<0.05).At the end of treatment,the carotid intima-media thickness(IMT),plaque area,and plaque number in the two groups were lower than those on the second day of admission,and the combined group was lower than the base group,with a statistically significant difference (P < 0.05). At the end of treatment, the levels of low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC) in both groups were lower than those on the second day of admission, while their high density lipoprotein cholesterol (HDL-C) was significantly higher than those on the second day of admission;The improvement of various indicators of blood lipids in the combined group was greater than that in the basic group, with a statistically significant difference (P < 0.05). The effective rate of treatment in the combined group (95.12%) was higher than that in the base group (80.49%), with a statistically significant difference (P < 0.05). At the end of treatment, the levels of endothelin-1 (ET-1) and vascular endothelial growth factor (VEGF) in both groups were lower than those on the second day of admission, and their nitric oxide (NO) content was significantly higher than that on the second day of admission. The improvement of vascular endothelial indicators in the combined group was greater than that in the base group, with a statistically significant difference (P < 0.05). Conclusion The application of rosuvastatin on the basis of insulin glargine can significantly improve the vascular endothelial function of type 2 diabetes patients with vascular complications, it is effective.