高血压合并糖尿病患者甘油三酯与小而密低密度脂蛋白的变化及洛伐他汀的干预作用

Changes of Triglycerin and Small Dense Low-Density Lipoprotein in Patients With Hypertension Complicated by Diabetes and Effects of Lovastatin Treatment

目的 :研究高血压及高血压合并糖尿病患者血浆中甘油三酯 (TG)与小而密低密度脂蛋白 (SdLDL)的变化规律及洛伐他汀调脂药物对其的干预效果。 方法 :按照 1 999年世界卫生组织 (WHO) /国际高血压联盟 (ISH)高血压的标准入选 1 32例高血压患者 ,其中高血压无合并症 58例 ,高血压伴糖尿病 74例 ,根据TG水平分为TG正常组 (TG <1 7mmol/L ,n =52 ) ,TG增高组 (TG≥ 1 7mmol/L ,n =80 )。对上述患者进行每日洛伐他汀 2 0mg治疗 ,共 8周。治疗前后进行血脂 5个组分的测定。 结果 :①所有高血压患者TG增高组SdLDL及TG值均明显高于TG正常组 (P <0 0 5～ 0 0 1 ) ,高密度脂蛋白胆固醇(HDL C)低于TG正常组 (P <0 0 1 ) ,均有显著差异。两组中TC及低密度脂蛋白胆固醇 (LDL C)无差异。②洛伐他汀可使高血压合并糖尿病TG增高组患者各指标与治疗前相比均具有显著差异 (P <0 0 5～ 0 0 1 )。③高血压合并糖尿病患者中 ,治疗前TG增高组的SdLDL及TG值增高的程序明显高于单纯高血压患者的TG正常组 ,TG增高组SdLDL的增高与TG的升高呈正相关 (γ =0 4 2 ,P <0 0 5)。 结论 :高血压患者中 ,当TG≥ 1 7mnol/L时 ,其SdLDL呈增高趋势 ,高血压合并糖尿病者TG水平明显高于正常值 ,并伴有相关的SdLDL的增高。

Objective:To investigate the changes of triglycerin(TG)and small dense low density lipoprotein(SdLDL)in hypertension and diabetes,and to evaluate the effects of lovatatin. Methods:One hundred thirty tow hypertensive patients were selected according to the 1999 WHO/ISH Guidelines for the management of hypertension,in whom there were 58 patients with hypertension only and 74 with hypertension and diabetes.The patients were divided into group A(TG<1 7 mmol/L)and group B(TG≥1 7 mmol/L).The indexes of cholesterol(TC),SdLDL,TG,high density lipoprotein cholesterol(HDL C)and low density lipoprotein cholesterol(LDL C)were obtained before and after lovastatin treatment(20 mg daily). Results:①In those of group B SdLDL and TG values were significantly higher than those of group A,but HDL C was obviously lower than that of group A,(p<0 05).There werent any differences of TC and LDL C between groups.②In group B,TG,LDL C and SdLDL decreased significantly(0 6 mmol/L,0 66 mml/L and 0 66 mmol/L,respectively)after lovastatin treatment.③In patients with hypertension and diabetes,SdLDL was in normal range in group A and elevated obviously in group B. Conclusion:SdLDL had increased tendency in patients with hypertension and elevated TG(>1 7 mmol/L).TG increased significantly in patients with hypertension and diabetes accompanied by elevated SdLDL.Lovastatin can correct the plasma lipid disturbance in these patients.