摘要
目的观察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。方法选择2015年2月—2017年2月河北省廊坊市中医医院内分泌科收治的糖尿病并发动脉粥样硬化患者98例作为研究对象,按照随机数字表法分为观察组和对照组49例。2组患者均进行常规运动干预和饮食调整,并治疗基础疾病。对照组在常规治疗基础上给予阿司匹林片100 mg/次,1次/d,晚餐前服用;观察组在对照组治疗基础上加服阿托伐他汀钙片20 mg/次,1次/d;2组患者连续治疗6个月。分别于治疗前后检测2组患者FPG、FINS、Hb A1c;采用酶法检测TC、TG、HDL-C、LDL-C水平;采用硫代巴比妥酸法检测SOD,羟基法检测MDA,荧光法检测LPO;比较2组患者颈动脉斑块厚度、颈动脉内膜中层厚度变化情况,并记录2组患者并发症发生情况。结果治疗后,观察组FPG、FINS、Hb A1c低于对照组(t=3.579、2.336、13.360,P=0.001、0.011、0.000);观察组TC、TG、LDL-C明显低于对照组,HDL-C显著高于对照组(t=3.968、1.994、16.856、2.586,P=0.000、0.029、0.000、0.005);观察组SOD明显高于对照组,MDA、LPO显著低于对照组(t=2.709、6.095、4.373,P=0.004、0.000、0.000);观察组颈动脉斑块厚度、颈动脉内膜中层厚度显著低于对照组(t=39.598、51.972,P=0.000、0.000);观察组发生冠心病、糖尿病周围神经病变、眼底病、脑血管疾病、糖尿病肾病等并发症发生率明显低于对照组(χ~2=4.382、5.231、5.869、3.971、5.869,P=0.036、0.022、0.016、0.046、0.016)。结论阿司匹林联合阿托伐他汀钙治疗糖尿病并发动脉粥样硬化,能够降低血糖水平,改善血脂水平,减轻应激反应,降低动脉粥样硬化斑块,值得临床推广应用。
Objective To investigate the effects of aspirin combined with statins on blood glucose and blood lipid in patients with diabetes mellitus and atherosclerosis.Methods Ninety-eight cases of patients with diabetes mellitus and atherosclerosis were selected,which were treated in hospital from February 2015 to February 2017,and they were divided into study group(49 cases)and control group(49 cases).The patients of two groups were all treated with routine exercise intervention and diet adjustment,and treatment of underlying diseases.The patients of control group were treated with aspirin tablets(100 mg/time,1 time/d,before taking meals).Based on the control group,the patients of study group were treated with atorvastatin calcium(oral,20 mg/time,1 time/d).The patients of 2 groups were all treated for 6 months.Compare the complications and changes of FPG,FIN,HbA 1c,TC,TG,HDL-C,LDL-C,SOD,MDA,LPO,carotid plaque thickness,carotid intima media thickness levels of two groups.Results After the appropriate treatment,the FPG,FINS,HbA 1c levels in the study group were significantly lower than those in the control group(t=3.579,t=2.336,t=13.360;P=0.001,P=0.011,P=0.000).The TC,TG,LDL-C levels in the study group were significantly lower than those in the control group,and the HDL-C levels in the study group were significantly higher than those in the control group(t=3.968,t=1.924,t=16.856,t=2.586;P=0.000,P=0.029,P=0.000,P=0.005).The SOD levels in the study group were significantly higher than those in the control group,and the MDA,LPO levels in the study group were significantly lower than those in the control group(t=2.709,t=6.095,t=4.373;P=0.004,P=0.000,P=0.000).The carotid plaque thickness,carotid intima media thickness levels in the study group were significantly lower than those in the control group(t=39.598,t=51.972;P=0.000,P=0.000).The incidence of coronary heart disease,diabetic peripheral neuropathy,fundus,cerebrovascular disease,diabetic nephropathy and other complications in the study group was significantly lower than that in the control group(χ2=4.382,χ2=5.231,χ2=5.869,χ2=3.971,χ2=5.869;P=0.036,P=0.022,P=0.016,P=0.046,P=0.016).Conclusion Aspirin combined with statins in the treatment of diabetes mellitus with atherosclerosis can reduce blood glucose levels,improve blood lipid levels,reduce stress response,reduce atherosclerotic plaque,which makes it worthy of clinical application.
作者
赵丽娜
马国库
高亚楠
沈悦
ZHAO Lina;MA Guoku;GAO Yanan;SHENG Yue(Department of Endocrinology,Langfang Hospital of Traditional Chinese Medicine,Hebei Province,Langfang 065000,China)
出处
《疑难病杂志》
CAS
2018年第4期357-361,共5页
Chinese Journal of Difficult and Complicated Cases
