辛伐他汀和罗格列酮对糖尿病患者动脉粥样硬化的影响

目的研究辛伐他汀和罗格列酮对2型糖尿病患者动脉粥样硬化的作用。方法 78例2型糖尿病伴颈动脉粥样斑块患者随机分为辛伐他汀组、罗格列酮组和联合组,分别口服辛伐他汀20mg/次、罗格列酮4mg/次及辛伐他汀20mg+罗格列酮4mg/次,每日1次,疗程3个月。在基线水平和疗程结束时经颈动脉超声检测CIMT,同时检测患者脂肪因子和炎症因子水平。观察治疗前后颈动脉内膜中层厚度及斑块变化。结果各组用药治疗3月后血脂、脂肪因子和炎性因子降低,CIMT厚度减低、斑块面积缩小,但斑块数量无减少,且联合用药比单一用药效果更显著。结论 2型糖尿病患者联合使用辛伐他汀和罗格列酮可改善胰岛素抵抗、改善脂类代谢、抑制大血管炎症反应、稳定和缩小动脉粥样斑块。

The effect of simvastatin and rosiglitazone on atherosclerosis in patients with type 2 diabetes

Objective To investigate the effect of simvastatin and rosiglitazone on atherosclerosis in patients with type 2 diabetes.Methods 78 cases of type 2 diabetes patients with carotid atheromatous plaque were randomly divided into three groups: simvastatin group,rosiglitazone group and simvastatin add rosiglitazone group.Oral simvastatin 20 mg/time respectively,1 time/day;rosiglitazone 4 mg/time,1 time/day;simvastatin 20 mg and rosiglitazone 4 mg/time,1 time/day.Treatment for 3 months.At baseline and at the end of the period of treatment we had detected carotid intima-media thickness by carotid ultrasound,simultaneously detected adipokines and inflammatory factors level.To observe the treatment of carotid intima-media thickness changes,research simvastatin and rosiglitazone alone or the united treatment on atherosclerosis.Results Each group of drug treatment after 3 months serum lipid,adipokine and inflammatory factor were reduced,the carotid intima-media thickness to decrease,the number of carotid atheromatous plaque do not decreases,combination with simvastatin and rosiglitazone than simvastatin or rosiglitazone better effect.Conclusion Simvastatin and rosiglitazone combination therapy in patients with type 2 diabetes can improve insulin resistance,inhibiting large blood vessels inflammation,stabilizing and narrowing the atheromatous plaque,antiatherosclerosis,its effect is greater than those simvastatin or rosiglitazone.