依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床效果

摘要

目的 探讨依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床疗效.方法 选取2013年6月至2014年6月于解放军总医院接受治疗的2型糖尿病合并高脂血症患者140例,根据随机数字表法分成观察组和对照组,各70例.对照组在常规治疗的基础上给予瑞舒伐他汀10 mg,1次/d口服.观察组在常规治疗的基础上分别给予瑞舒伐他汀10 mg和依折麦布10 mg,1次/d口服.2组均治疗3个月.治疗前和治疗3个月后,检测并比较2组空腹胰岛素、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,并记录LDL-C ＜4.14 mmol/L及＜3.37 mmol/L的患者比例以及不良反应发生情况.结果 治疗前,观察组与对照组患者空腹胰岛素、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、LDL-C、HDL-C水平和LDL-C＜4.14 mmoL/L及＜3.37 mmol/L的患者比例比较,差异均无统计学意义(均P ＞0.05).治疗后,2组总胆固醇、三酰甘油、LDL-C水平明显低于治疗前,且观察组低于对照组[(3.5±0.7) mmol/L比(4.2±0.6)mmol/L、(1.28±0.12) mmol/L比(1.49±0.14) mmol/L、(3.2±0.6)mmol/L比(4.0 ±0.8) mmol/L],差异均有统计学意义(均P＜0.05).2组治疗后LDL-C＜4.14 mmol/L及＜3.37 mmol/L的患者比例均高于治疗前,且观察组高于对照组[62.9％ (44/70)比28.6％(20/70)、90.0％(63/70)比67.1％(47/70)],差异均有统计学意义(均P＜0.05).2组治疗前后丙氨酸转氨酶、天冬氨酸转氨酶、肌酸激酶水平以及治疗后胃肠道反应发生情况比较,差异均无统计学意义(均P＞0.05).结论 依折麦布联合瑞舒伐他汀治疗2型糖尿病合并高脂血症的临床疗效优于单纯使用瑞舒伐他汀治疗.%Objective To explore the effect of ezetimibe combined with rosuvastatin in treating type 2 diabetes mellitus complicated with hyperlipidemia.Methods Totally 140 cases with type 2 diabetes mellitus complicated with hyperlipidemia from June 2013 to June 2014 were randomly divided into observation group and control group (70 cases in each group).Both groups received conventional treatment;control group was added rosuvastatin (10 mg,l time/d,orally);observation group was added rosuvastatin (10 mg,1 time/d,orally) and ezetimibe (10 mg,1 time/d,orally).The treatment lasted for 3 months.The levels of fasting insulin,fasting glucose,glycosylated hemoglobin,triacylglycerol,total cholesterol,low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) before and after treatment.The ratios of cases with LDL-C ＜ 4.14 mmol/L and ＜ 3.37 mmol/L and the incidence of adverse reactions were recorded.Results The levels of fasting insulin,fasting glucose,glycosylated hemoglobin,total cholesterol,triacylglycerol,LDL-C,HDL-C,ratios of cases with LDL-C ＜ 4.14 mmol/L and ＜ 3.37 mmol/L before treatment were not significantly different between groups (P ＞ 0.05).After treatment,the levels of total cholesterol,triacylglycerol,LDL-C were significantly decreased in both groups,and were significantly lower in observation group than those in control group [(3.5 ± 0.7) mmol/L vs (4.2±0.6) mmol/L,(1.28 ±0.12) mmol/L vs (1.49±0.14) mmol/L,(3.2 ±0.6) mmol/L vs (4.0 ± 0.8) mmol/L],the ratios of cases with LDL-C ＜ 4.14 mmol/L and ＜ 3.37 mmol/L were significantly increased,and were significantly higher in observation than those in control group [62.9％ (44/70) vs 28.6％ (20/70),90.0％ (63/70)vs67.1％ (47/70)] (P＜0.05).The levels of alanine aminotransferase,aspartate aminotransferase,creatine kinase and incidence of gastrointestinal reaction before and after treatment were not significantly different between groups (P ＞ 0.05).Conclusion Ezetimibe combined with rosuvastatin has better effect compared with single rosuvastatin in treating type 2 diabetes mellitus complicated with hyperlipidemia