摘要
目的:观察辛伐他汀联合依折麦布对合并糖耐量减低急性冠状动脉综合征(ACS)的患者的血脂及血糖的影响。方法:选择316例合并糖耐量减低的ACS患者,随机分为治疗组(n=160)和对照组(n=156),对照组患者采用辛伐他汀20 mg/d治疗,治疗组患者采用辛伐他汀20 mg/d联合依折麦布10 mg/d治疗,观察两组治疗6、12、24个月总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)以及两组治疗6天、12、24个月空腹血糖(FBG)、餐后2 h血糖、糖化血红蛋白(HbA_(1c))、新发糖尿病例数的变化。结果:治疗6个月时,治疗组TC和LDL-C水平分别为(3.5±0.5)mmol/L和(2.1±0.4)mmol/L,与基线水平[(5.2±1.2)mmol/L和(3.5±0.5)mmol/L]比较均降低(P均<0.05);治疗12个月时,治疗组的TC和LDL-C水平分别为(3.1±1.0)mmol/L和(1.8±0.6)mmol/L,较基线水平进一步降低(P<0.05);治疗24个月时,治疗组的TC和LDL水平分别为(3.0±0.6)mmol/L和(1.8±0.5)mmol/L,持续降低(P<0.05)。治疗6个月时,对照组的TC和LDL-C分别为(4.0±0.5)mmol/L和(2.4±0.5)mmol/L,均低于基线水平[(5.3±0.8)mmol/L和(3.1±0.4)mmol/L,P<0.05];治疗12个月、24个月时TC和LDL-C分别是(3.8±0.6)mmol/L、(2.3±0.4)mmo1/L和(3.7±0.5)mmol/L、(2.1±0.7)mmol/L,均持续低于基线水平(P均<0.05)。治疗组治疗6、12、24个月时TC、LDL-C水平均低于对照组(P<0.05)。两组治疗12、24个月时FBG与治疗6天比较差异均无统计学意义(P>0.05);HbA_(1c)在治疗12、24个月时与基线水平比较差异无统计学意义(P>0.05)。治疗组治疗24个月时餐后2 h血糖(9.5±1.1)mmol/L较治疗6天时(8.7±1.0)mmol/L升高(P<0.05),共新发生糖尿病患者26例。对照组治疗24个月时餐后2 h血糖(9.6±0.8)mmol/L较治疗6天时(8.7±0.7)mmol/L升高(P<0.05),共新发糖尿病患者25例。治疗组与对照组比较,治疗6天和治疗12、24个月FBG、餐后2 h血糖、HbA_(1c)及新发糖尿病例数差异均无统计学意义(P均>0.05)。结论:辛伐他汀联合依折麦布能更有�
Objective： To observe the influence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome （ACS） with impaired glucose tolerance （IGT）. Methods： A total of 316 patients with ACS and IGT were randomly divided into 2 groups： Treatment group, the patients received simvastatin 20 rag/day with ezetimibe 10 mg/day, n=160 and Control group, the patients received simvastatin 20 mg/day, n=156. All patients were treated for 24 months. Blood levels of total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） were observed at 6, 12 and 24 months of medication; fasting blood glucose （FBG）, 2 hourpostprandial blood glucose （2hPG）, glycosylated hemoglobin （HbAlc） and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication. Results： ① In Treatment group, at 6 months of medication, blood levels of TC （mmol/L） and LDL-C （mmol/L） were （3.5 ± 0.5） and （2.1 ± 0.4） which were both lower than baseline levels （5.2±1.2） and （3.5±0.5）, P〈0.05; at 12 and 24 months, TC and LDL-C were （3.1±1.0）, （1.8±0.6） and （3.0±0.6）, （1.8±0.5）, TC and LDL-C were consistently decreased, all P〈0.05. In Control group, at 6 months of medication, TC and LDL-C were （4.0±0.5） and （2.4±0.5） which were both lower than baseline levels （5.3± 0.8） and （3.1±0.4）, P〈0.05; at 12 and 24 months, TC and LDL-C were （3.8±0.6）, （2.3±0.6） and （3.7 ± 0.5）, （2.1 ± 0.7）, all P〈0.05. TC and LDL-C levels in Treatment group were lower than Control group at 6, 12 and 24 months of medication, all P〈0.05. ② In Treatment group, FBG （mmol/L） levels at 12 and 24 months were similar to 6 days, P〉0.05; HbAlc at 12 and 24 months were similar to baseline, P〉0.05; 2hPG （mmol/L） level at 24 months was higher than 6 days （9.5±1.1） vs （8.7±1.0）, P〈0.05; there were 26 patients with new onset diabetes at 24 months after me
出处
《中国循环杂志》
CSCD
北大核心
2015年第10期954-957,共4页
Chinese Circulation Journal
