瑞舒伐他汀和氟伐他汀治疗急性冠状动脉综合征合并糖耐量减低患者的疗效观察

摘要

Objective:To investigate the effects of rosuvastatin and lfuvastatin on patients with acute coronary syndrome (ACS) combing impaired glucose tolerance (IGT). Methods: A total of 215 consecutive ACS patients combing IGT treated in our hospital from 2009-05 to 2011-05 were studied. The patients were randomly divided into 2 groups, Rosuvastatin group, the patients received rosuvastatin10mg/day, n=108 and Fluvastatin group, the patients received fluvastatin 40mg/day, n=107. The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) levels before and at 6, 12, 24 months after medication, fasting blood glucose (FBG), 2-hour postprandial glucose (2hPBG) and the number of new-onset of diabetes patients were compared between 2 groups. Results: After treatment, the TC, LDL-C levels were decreased (6, 12, 24 months) and the HDL-C level (12, 24 months), 2hPBG (24 months) were increased in both groups. Compared with Fluvastatin group, Rosuvastatin group had decreased TC and LDL-C (6, 12, 24 months), and increased LDL-C (24 months). With 6, 12, 24 months treatment, the blood lipids reached the standard were more in Rosuvastatin group than those in Fluvastatin group as 35.3%vs 26.1%, 36.4% vs 22.0%, 43.1% vs 31.8% respectively, all P<0.05. With 12 and 24 months treatment, the new-onset diabetes patients in Rosuvastatin group were 11 and 18, in Fluvastatin group were 12 and 17. With 12, 24 months treatment, FBG, 2hPBG levels and the number of new-onset diabetes patients were similar between 2 groups, P>0.05. Conclusion: Compared with lfuvastatin, the conventional dose of rosuvastatin could better reduce the blood lipids level in ACS patients combing IGT, the effects for preventing ACS patients from IGT to diabetes were similar for both drugs.%目的：探讨瑞舒伐他汀和氟伐他汀对急性冠状动脉（冠脉）综合征（ACS）合并糖耐量减低（IGT）患者血脂、血糖的影响。　　方法：连续选取我院2009-05至2011-05收治的ACS合并IGT的患者215例，随机分为两组：治疗时服用瑞舒伐他汀10 mg/d者为瑞舒伐他汀组（n=108），服用氟伐他汀40 mg/d者为氟伐他汀组（n=107），观察两组患者治疗前、治疗后6、12、24个月总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）以及空腹血糖、餐后2h血糖、新发糖尿病例数。　　结果：瑞舒伐他汀组、氟伐他汀组治疗后与本组治疗前比较，TC、LDL-C（6、12、24个月）降低、HDL-C （12、24个月）、餐后2 h血糖（24个月）均升高；瑞舒伐他汀组治疗6、12、24个月时与氟伐他汀组同期比较，TC和LDL-C均降低，HDL-C（24个月）升高。治疗6、12、24个月时瑞舒伐他汀组血脂达标率与氟伐他汀组同期比较均高（35.3%vs 26.1%；36.4% vs 22.0%；43.1%vs 31.8%）,上述比较差异均有统计学意义（P<0.05）。治疗12、24个月时瑞舒伐他汀组新发糖尿病分别为11、18例,而氟伐他汀组分别为12、17例。瑞舒伐他汀组12、24个月时空腹血糖、餐后2 h血糖水平和新发糖尿病例数与氟伐他汀组相比差异无统计学意义（P>0.05）。　　结论：常规剂量的瑞舒伐他汀降低ACS合并IGT患者的血脂水平的效果优于常规剂量的氟伐他汀，两药在常规剂量治疗时此类患者由糖耐量减低转化为糖尿病的风险相当。