摘要
目的前瞻性观察瑞舒伐他汀钙对老年2型糖尿病(Type 2Diabetes Mellitus,T2DM)合并缺血性脑卒中患者颈动脉硬化、血脂、hs-CRP的疗效,为老年T2DM合并缺血性脑卒中的二级预防提供更多的临床证据。方法将我院老年T2DM合并急性ICVD患者226例,随机分成2组:(1)治疗组:瑞舒伐他汀钙片5mg/d+阿司匹林肠溶片0.1g/d+降糖药;(2)对照组:洛伐他汀胶囊20mg/d+阿司匹林肠溶片0.1g/d+降糖药,检测基线及入组后6月、12月、24月时的血浆hsCRP和血脂等各项指标,同时做颈动脉彩色多普勒超声检测基线及入组后6月、12月、24月时颈动脉内—中膜厚度(IMT)。结果在入组后6月、12月、24月时,治疗组的血浆hs-CRP和血脂水平低于对照组(P<0.05);2组在入组后6月、12月、24月时,2组的颈动脉彩色多普勒超声检测指标均优于入院时的基线水平,有显著性差异和极显著性差异(P<0.05,P<0.01);在入组后12月、24月时治疗组的超声检测指标优于对照组,有显著性差异和极显著性差异(P<0.05,P<0.01)。结论瑞舒伐他汀钙片可显著降低老年T2DM合并缺血性脑卒中患者的血脂、hs-CRP,并有逆转颈动脉粥样硬化斑块的作用,且疗效明显优于洛伐他汀胶囊,为老年T2DM合并急性ICVD的防治提供理论依据。
Objective To prospectively study of the effect of rosuvastatin on carotid atherosclerotic plaques ,lipid and high-sensitivity CRP （hs-CRP） in patients with elderly type 2 diabetic and ischemic stroke ,and to provide evidence for clinical practice on the secondary prevention of stroke.Methods Two hundred and twenty-six cases of elderly type 2 diabetes mellitus （T2DM ） and acute ICVD from the hospitalized patients were randomly divided into two groups ：（1）the treatment group ,108 cases received the treatment of rosuvastatin 5 mg （qn） ＋ aspirin 100 mg （qd） and antidiabetic drug ;（2） the control group , 113 cases received the treatment of luofastatin 20 mg （qn） ＋ aspirin 100 mg （qd） and antidiabetic drug.The serum levels of hs-CRP and lipids of all patients were measured before and 6 months ,12 months and 24 months after treatment ,at the same period ,carotid intimae-media thickness （IMT） was measured with color Doppler ultrasound .Results Compared with the control group ,the level of hs-CRP and lipids decreased significantly at 6 months ,12 months and 24 months after the treatment of rosu-vastatin （P〈0.05）. Compared with that before treatment ,IMT of the both group decreased at 6 months ,12 months and 24 months after the treatment （P〈0.05） ,and it decreased significantly at 12 months and 24 months after the treatment of rosuv-astatin （P〈0.01）. Conclusion Rosuvastatin can obviously decrease the level of hs-CRP and lipids in patients with elderly type 2 diabetic and ischemic stroke ,and reversing the carotid atherosclerotic plaque ,and the curative effect is obviously superior tolovastatin capsules.
出处
《中国实用神经疾病杂志》
2014年第10期25-27,共3页
Chinese Journal of Practical Nervous Diseases
