不同剂量瑞舒伐他汀对老年冠心病合并糖尿病患者脂代谢与同型半胱氨酸水平的影响
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摘要
目的观察不同剂量瑞舒伐他汀对老年冠心病合并糖尿病患者脂代谢与同型半胱氨酸水平的影响。方法选取北京市海淀医院2016年5月～2017年5月收治的老年糖尿病合并冠心病患者100例,按照随机数字表法将其分为对照组和观察组,每组各50例。对照组口服低剂量瑞舒伐他汀片10 mg/次,1次/d,观察组口服高剂量瑞舒伐他汀片20 mg/次,1次/d,疗程均为6个月。观察两组患者治疗前、治疗后1、6个月总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、同型半胱氨酸(Hcy)及治疗前后血浆纤维蛋白原(Fg)水平。结果治疗前两组患者TG、TC、LDL-C、HDL-C、Hcy、Fg比较,差异无统计学意义(P> 0.05)。治疗后1、6个月两组TG、TC、LDL-C、Hcy均较治疗前降低,且观察组TG、TC、LDL-C、Hcy水平均低于对照组(P <0.05)。治疗后1、6个月两组患者HDL-C均升高,观察组高于对照组(P <0.05)。两组患者治疗后1、6个月Fg降低,且观察组低于对照组(P <0.05)。结论大剂量瑞舒伐他汀能更有效控制老年冠心病合并糖尿病患者的血脂、Fg和Hcy水平。
Objective To observe the effects of different doses of rosuvastatin on lipid metabolism and homocysteine levels in elderly patients with coronary heart disease and diabetes mellitus. Methods From May 2016 to May 2017, 100 elderly patients with diabetes mellitus and coronary heart disease admitted to Beijing Haidian Hospital were selected and divided into control group and observation group according to the random number table method, with 50 cases in each group. The control group received low-dose Risuvastatin Tablets at 10 mg/time and once a day, while the observation group received high-dose Risuvastatin Tablets at 20 mg/time and the course of treatment was 6 months. Total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), homocysteine(Hcy) and plasma fibrinogen(Fg) levels before and after treatment were observed in the two groups. Results Before treatment, TG, TC, LDL-C, HDL-C, Hcy and Fg of the two groups were compared, and the differences were not statistically significant(P > 0.05). At 1,6 months after treatment, TG, TC, LDL-C and Hcy in the two groups were all decreased. The levels of TG, TC, LDL-C and Hcy in the observation group were lower than those in the control group at 1 month and 6 months after treatment(P < 0.05). HDL-C increased in both groups 1,6 months after treatment, and was higher in the observation group than the control group(P < 0.05). Fg was decreased in the two groups 1,6 months after treatment, and the observation group was lower than that in the control group(P < 0.05). Conclusion Large dose of Rosuvastatin can effectively control blood lipid, Fg and Hcy levels in elderly patients with coronary heart disease and diabetes mellitus.
Objective To observe the effects of different doses of rosuvastatin on lipid metabolism and homocysteine levels in elderly patients with coronary heart disease and diabetes mellitus. Methods From May 2016 to May 2017, 100 elderly patients with diabetes mellitus and coronary heart disease admitted to Beijing Haidian Hospital were selected and divided into control group and observation group according to the random number table method, with 50 cases in each group. The control group received low-dose Risuvastatin Tablets at 10 mg/time and once a day, while the observation group received high-dose Risuvastatin Tablets at 20 mg/time and the course of treatment was 6 months. Total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), homocysteine(Hcy) and plasma fibrinogen(Fg) levels before and after treatment were observed in the two groups. Results Before treatment, TG, TC, LDL-C, HDL-C, Hcy and Fg of the two groups were compared, and the differences were not statistically significant(P > 0.05). At 1,6 months after treatment, TG, TC, LDL-C and Hcy in the two groups were all decreased. The levels of TG, TC, LDL-C and Hcy in the observation group were lower than those in the control group at 1 month and 6 months after treatment(P < 0.05). HDL-C increased in both groups 1,6 months after treatment, and was higher in the observation group than the control group(P < 0.05). Fg was decreased in the two groups 1,6 months after treatment, and the observation group was lower than that in the control group(P < 0.05). Conclusion Large dose of Rosuvastatin can effectively control blood lipid, Fg and Hcy levels in elderly patients with coronary heart disease and diabetes mellitus.
引文
[1]Haver VG,Mateo Leach I,Kjekshus J,et al.Telomere length and outcomes in ischaemic heart failure:data from the controlled osuvastatin multinational Trial in Heart Failure(corona)[J].Eur J Heart Fail,2015,17(3):313-319.DOI:10.1002/ejhf.237.
[2]阎国辉,张洋,智光,等.高血脂小鼠Th1/Th2细胞因子的检测及相关性分析[J].中国动脉硬化杂志,2007,15(4):293-295.
[3]Mizukami H,Ogasawara S,Yamagisshi S,et al.Methylcobalam in effects on diabetic neuropathy and never protein kinase C in rats[J].Eur Clin Invest,2011,41(4):442-450.
[4]冯健,董兴刚,俞志满.瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸与高敏C反应蛋白及血脂的影响[J].中国医药,2015,10(5):649-651.
[5]胡广卉,武云涛,赵保钢,等.匹伐他汀钙联合依折麦布治疗高龄冠心病合并2型糖尿病患者的疗效及安全性[J].中国循证心血管医学杂志,2016,8(12):1466-1469.
[6]程清.脂蛋白相关磷脂酶A2和同型半胱氨酸水平与动脉粥样硬化性心脑血管疾病关系的研究[J].检验医学,2015,12(1):40-43.
[7]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2014:213-214.
[8]Toso A,Leoncini M,Maioli M,et al.Relationship Between Inflammation and Benefits of Early High-Dose Rosuvastatin on Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome The Pathophysiological Link in the PRATO-ACS Study(Protective Effect of Rosuvastatin and Antiplatelet Therapy on Contrast-Induced Nephropathy and Myocardial Damage in Patients With Acute Coronary Syndrome Undergoing Coronary Intervention)[J].JACC Cardiovasc interv,2014,7(12):1421-1429.
[9]田杰,卢建刚,曾秋蓉,等.同型半胱氨酸和颈动脉内膜中层厚度与老年冠心病严重程度的相关性[J].中华老年心脑血管病杂志,2015,21(3):266-269.
[10]Joshi PH,Khokhar AA,Massaro JM,et al.Remnant lipoprotein cholesterol and incident coronary heart disease:the Jackson Heart and Framingham Offspring Cohort Studies[J]J Am Heart Assoc,2016,5(5):e002765.
[11]江帆.同型半胱氨酸与老年冠心病合并2型糖尿病患者心功能的相关研究[J].海南医学,2016,27(12):1926-1928.
[12]孙丽娜.N-乙酰半胱氨酸对糖尿病大鼠肾脏VEGF、MCP-1表达的影响[J].中国现代医学杂志,2013,23(19):21-25.
[13]张洪,薛蕾.血清同型半胱氨酸水平与冠状动脉粥样硬化程度相关性的研究[J].中国医药指南,2013,12(20):218-218.
[14]郭清华,陆菊明,秦海红,等.2型糖尿病微血管病变患者血浆同型半胱氨酸的变化及其机制的探讨[J].中国糖尿病杂志,2002,10(1):32-35.
[15]陆菊明,谷伟军.同型半胱氨酸-糖尿病血管病变的新型危险因素[J].军医进修学院院报,2009,30(3):249-250.
[16]任丽燕,朱志峰.不同水平同型半胱氨酸对糖尿病合并高血压患者颈动脉斑块积分的影响[J].中国现代医生,2017,55(28):28-30,35.
[17]刘湘茹,李玥,杨斌,等.2型糖尿病患者血浆同型半胱氨酸水平及相关因素分析[J].中国当代医药,2018,25(14):63-65.
[18]邓咏秋,李明亮.瑞舒伐他汀联合通心络治疗冠状动脉粥样硬化型心脏病的观察[J].现代临床医学,2013,39(3):194-195.
[19]汪蓓蕾,华锦胜,胡章乐,等.瑞舒伐他汀与阿托伐他汀对经皮冠状动脉介入治疗患者术后血浆白介素-18浓度的影响[J].中国临床保健杂志,2015,18(6):615-617
[20]马海英,铁虎光,韩荣胜.不同剂量瑞舒伐他汀钙片治疗稳定型心绞痛并慢性心力衰竭临床疗效的对比研究[J].实用心脑肺血管病杂志,2017,25(5):56-60.
[21]岳豪祥,钱丽华,王文欣,等.瑞舒伐他汀治疗冠心病患者疗效观察及对患者凝血、血液流变学、血脂、细胞因子水平的影响[J].安徽医药,2016,20(4):772-775.
[22]冯建双.他汀类药物对急性心肌梗死血脂及炎症因子的影响[D].石家庄:河北医科大学,2014.
[23]刘玲,殷屹岗,阮中宝,等.血清Cyc-c和Hcy对冠状动脉病变严重程度的评估及瑞舒伐他汀的干预作用[J]中国实验诊断学,2014,18(10):1626-1627.
[2]阎国辉,张洋,智光,等.高血脂小鼠Th1/Th2细胞因子的检测及相关性分析[J].中国动脉硬化杂志,2007,15(4):293-295.
[3]Mizukami H,Ogasawara S,Yamagisshi S,et al.Methylcobalam in effects on diabetic neuropathy and never protein kinase C in rats[J].Eur Clin Invest,2011,41(4):442-450.
[4]冯健,董兴刚,俞志满.瑞舒伐他汀对老年2型糖尿病合并颈动脉斑块患者同型半胱氨酸与高敏C反应蛋白及血脂的影响[J].中国医药,2015,10(5):649-651.
[5]胡广卉,武云涛,赵保钢,等.匹伐他汀钙联合依折麦布治疗高龄冠心病合并2型糖尿病患者的疗效及安全性[J].中国循证心血管医学杂志,2016,8(12):1466-1469.
[6]程清.脂蛋白相关磷脂酶A2和同型半胱氨酸水平与动脉粥样硬化性心脑血管疾病关系的研究[J].检验医学,2015,12(1):40-43.
[7]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2014:213-214.
[8]Toso A,Leoncini M,Maioli M,et al.Relationship Between Inflammation and Benefits of Early High-Dose Rosuvastatin on Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome The Pathophysiological Link in the PRATO-ACS Study(Protective Effect of Rosuvastatin and Antiplatelet Therapy on Contrast-Induced Nephropathy and Myocardial Damage in Patients With Acute Coronary Syndrome Undergoing Coronary Intervention)[J].JACC Cardiovasc interv,2014,7(12):1421-1429.
[9]田杰,卢建刚,曾秋蓉,等.同型半胱氨酸和颈动脉内膜中层厚度与老年冠心病严重程度的相关性[J].中华老年心脑血管病杂志,2015,21(3):266-269.
[10]Joshi PH,Khokhar AA,Massaro JM,et al.Remnant lipoprotein cholesterol and incident coronary heart disease:the Jackson Heart and Framingham Offspring Cohort Studies[J]J Am Heart Assoc,2016,5(5):e002765.
[11]江帆.同型半胱氨酸与老年冠心病合并2型糖尿病患者心功能的相关研究[J].海南医学,2016,27(12):1926-1928.
[12]孙丽娜.N-乙酰半胱氨酸对糖尿病大鼠肾脏VEGF、MCP-1表达的影响[J].中国现代医学杂志,2013,23(19):21-25.
[13]张洪,薛蕾.血清同型半胱氨酸水平与冠状动脉粥样硬化程度相关性的研究[J].中国医药指南,2013,12(20):218-218.
[14]郭清华,陆菊明,秦海红,等.2型糖尿病微血管病变患者血浆同型半胱氨酸的变化及其机制的探讨[J].中国糖尿病杂志,2002,10(1):32-35.
[15]陆菊明,谷伟军.同型半胱氨酸-糖尿病血管病变的新型危险因素[J].军医进修学院院报,2009,30(3):249-250.
[16]任丽燕,朱志峰.不同水平同型半胱氨酸对糖尿病合并高血压患者颈动脉斑块积分的影响[J].中国现代医生,2017,55(28):28-30,35.
[17]刘湘茹,李玥,杨斌,等.2型糖尿病患者血浆同型半胱氨酸水平及相关因素分析[J].中国当代医药,2018,25(14):63-65.
[18]邓咏秋,李明亮.瑞舒伐他汀联合通心络治疗冠状动脉粥样硬化型心脏病的观察[J].现代临床医学,2013,39(3):194-195.
[19]汪蓓蕾,华锦胜,胡章乐,等.瑞舒伐他汀与阿托伐他汀对经皮冠状动脉介入治疗患者术后血浆白介素-18浓度的影响[J].中国临床保健杂志,2015,18(6):615-617
[20]马海英,铁虎光,韩荣胜.不同剂量瑞舒伐他汀钙片治疗稳定型心绞痛并慢性心力衰竭临床疗效的对比研究[J].实用心脑肺血管病杂志,2017,25(5):56-60.
[21]岳豪祥,钱丽华,王文欣,等.瑞舒伐他汀治疗冠心病患者疗效观察及对患者凝血、血液流变学、血脂、细胞因子水平的影响[J].安徽医药,2016,20(4):772-775.
[22]冯建双.他汀类药物对急性心肌梗死血脂及炎症因子的影响[D].石家庄:河北医科大学,2014.
[23]刘玲,殷屹岗,阮中宝,等.血清Cyc-c和Hcy对冠状动脉病变严重程度的评估及瑞舒伐他汀的干预作用[J]中国实验诊断学,2014,18(10):1626-1627.
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