抗凝联合降血脂治疗糖尿病动脉粥样硬化的效果观察
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摘要
目的:探索抗凝治疗联合降血脂治疗用于糖尿病动脉粥样硬化患者的效果。方法:在笔者所在医院2017年1月-2018年5月收治的糖尿病合并动脉粥样硬化患者中选出134例为研究对象,随机分为两组,对照组患者给予常规对症治疗和抗凝治疗,观察组患者在对照组治疗措施基础上给予降血脂治疗。对比两组患者的血糖水平、血脂水平、斑块厚度等。结果:治疗6个月后,观察组患者的空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IRI)、颈动脉内膜中层厚度、斑块厚度、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,差异均有统计学意义(P<0.05);观察组患者高密度脂蛋白胆固醇(HDL-C)水平高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:抗凝联合他汀类药物降血脂治疗有助于促进糖尿病动脉粥样硬化患者血糖、血脂指标的控制,稳定斑块,减少糖尿病并发症发生,提高患者生活质量,值得推广应用。
Objective:To explore the effect of anticoagulation therapy combined with hypolipidemic therapy in patients with diabetic atherosclerosis.Method:A total of 134 patients with diabetes and atherosclerosis admitted to our hospital from January 2017 to May 2018,and they were randomly divided into two groups.Patients in the control group were given routine symptomatic treatment and anticoagulation therapy.Patients in the observation group were given hypolipidemic treatment on the basis of treatment measures in the control group.Blood sugar level,blood lipid level and plaque thickness were compared between the two groups.Result:After 6 months of treatment,the fasting blood sugar(FBG),fasting insulin(FINS),glycated hemoglobin(HbA1 c),insulin resistance index(HOMA-IRI),carotid intima-media thickness,plaque thickness,the levels of total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05),and the levels of high density lipoprotein cholesterol(HDL-C) in the observation group was higher than those of the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Anticoagulation combined with Statin drugs to reduce blood lipids can promote the control of blood sugar and blood lipids in patients with diabetes atherosclerosis,stabilize plaque,reduce the incidence of diabetes complications,improve the quality of life of patients,and it is worthy of popularization and application.
Objective:To explore the effect of anticoagulation therapy combined with hypolipidemic therapy in patients with diabetic atherosclerosis.Method:A total of 134 patients with diabetes and atherosclerosis admitted to our hospital from January 2017 to May 2018,and they were randomly divided into two groups.Patients in the control group were given routine symptomatic treatment and anticoagulation therapy.Patients in the observation group were given hypolipidemic treatment on the basis of treatment measures in the control group.Blood sugar level,blood lipid level and plaque thickness were compared between the two groups.Result:After 6 months of treatment,the fasting blood sugar(FBG),fasting insulin(FINS),glycated hemoglobin(HbA1 c),insulin resistance index(HOMA-IRI),carotid intima-media thickness,plaque thickness,the levels of total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05),and the levels of high density lipoprotein cholesterol(HDL-C) in the observation group was higher than those of the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Anticoagulation combined with Statin drugs to reduce blood lipids can promote the control of blood sugar and blood lipids in patients with diabetes atherosclerosis,stabilize plaque,reduce the incidence of diabetes complications,improve the quality of life of patients,and it is worthy of popularization and application.
引文
[1]Bornfeldt K E.2013 Russell Ross memorial lecture in vascular biology:Cellular and molecular mechanisms of diabetes mellitus-Accelerated atherosclerosis[J].Arterioscler Thromb Vasc Biol,2014,34(4):705-714.
[2]Ozturk D,Celik O,Satilmis S,et al.Association between serum galectin-3 levels and coronary atherosclerosis and plaque burden/structure in patients with type 2 diabetes mellitus[J].Coronary Artery Disease,2015,26(5):396-401.
[3]卢笑,吴欢欢,倪海祥.中医药治疗糖尿病下肢动脉粥样硬化的研究进展[J].黑龙江中医药,2016,45(3):76-78.
[4]Strang A C,Van Wijk D F,Mutsaerts H J,et al.Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus[J].Diabetes&Vascular Disease Research,2015,12(2):126-132.
[5]文敏,赵力敏,刘宋芳.抗凝联合降血脂治疗糖尿病动脉粥样硬化的疗效观察[J].中国生化药物杂志,2016,36(8):116-118.
[6]李苗苗,安莲华,张红梅,等.脂肪因子与糖尿病动脉粥样硬化相关性的研究进展[J].中国老年学杂志,2015,35(15):4388-4390.
[7]赵丽娜,马国库,高亚楠,等.阿司匹林联合阿托伐他汀治疗糖尿病并发动脉粥样硬化对血糖、血脂和氧化应激的影响[J].疑难病杂志,2018,17(4):357-361.
[8]万惠,姚伟峰,钱铁镛,等.血塞通对糖尿病动脉粥样硬化患者血脂尿酸代谢及氧化应激的影响[J].山西医药杂志,2017,46(16):2013-2015.
[9]杨蓥境.阿司匹林抗凝联合辛伐他汀降血脂对治疗糖尿病动脉粥样硬化的临床疗效观察[J].医学理论与实践,2017,30(22):3336-3338.
[10]姚洁,郭惠娟,袁华.抗凝联合降血脂治疗糖尿病动脉粥样硬化对胰岛素水平及血脂相关指标的影响观察[J].现代诊断与治疗,2018,29(19):3132-3134.
[11]房永录,郑伟平.脑心通胶囊联合阿托伐他汀对2型糖尿病血脂代谢及动脉粥样斑块的干预作用[J].浙江中西医结合杂志,2014,24(4):312-314.
[12]刘中华,王昃睿,王晓东.益气疏风通络方联合阿托伐他汀治疗2型糖尿病合并冠状动脉粥样硬化性心脏病疗效观察[J].中医学报,2018,33(5):751-755.
[2]Ozturk D,Celik O,Satilmis S,et al.Association between serum galectin-3 levels and coronary atherosclerosis and plaque burden/structure in patients with type 2 diabetes mellitus[J].Coronary Artery Disease,2015,26(5):396-401.
[3]卢笑,吴欢欢,倪海祥.中医药治疗糖尿病下肢动脉粥样硬化的研究进展[J].黑龙江中医药,2016,45(3):76-78.
[4]Strang A C,Van Wijk D F,Mutsaerts H J,et al.Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus[J].Diabetes&Vascular Disease Research,2015,12(2):126-132.
[5]文敏,赵力敏,刘宋芳.抗凝联合降血脂治疗糖尿病动脉粥样硬化的疗效观察[J].中国生化药物杂志,2016,36(8):116-118.
[6]李苗苗,安莲华,张红梅,等.脂肪因子与糖尿病动脉粥样硬化相关性的研究进展[J].中国老年学杂志,2015,35(15):4388-4390.
[7]赵丽娜,马国库,高亚楠,等.阿司匹林联合阿托伐他汀治疗糖尿病并发动脉粥样硬化对血糖、血脂和氧化应激的影响[J].疑难病杂志,2018,17(4):357-361.
[8]万惠,姚伟峰,钱铁镛,等.血塞通对糖尿病动脉粥样硬化患者血脂尿酸代谢及氧化应激的影响[J].山西医药杂志,2017,46(16):2013-2015.
[9]杨蓥境.阿司匹林抗凝联合辛伐他汀降血脂对治疗糖尿病动脉粥样硬化的临床疗效观察[J].医学理论与实践,2017,30(22):3336-3338.
[10]姚洁,郭惠娟,袁华.抗凝联合降血脂治疗糖尿病动脉粥样硬化对胰岛素水平及血脂相关指标的影响观察[J].现代诊断与治疗,2018,29(19):3132-3134.
[11]房永录,郑伟平.脑心通胶囊联合阿托伐他汀对2型糖尿病血脂代谢及动脉粥样斑块的干预作用[J].浙江中西医结合杂志,2014,24(4):312-314.
[12]刘中华,王昃睿,王晓东.益气疏风通络方联合阿托伐他汀治疗2型糖尿病合并冠状动脉粥样硬化性心脏病疗效观察[J].中医学报,2018,33(5):751-755.