瑞舒伐他汀钙对老年2型糖尿病合并缺血性脑卒中患者颈动脉硬化、血脂、hs-CRP疗效分析

摘要

目的：前瞻性观察瑞舒伐他汀钙对老年2型糖尿病（Type 2 Diabetes 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5 mg/d ＋阿司匹林肠溶片0.1 g/d＋降糖药；（2）对照组：洛伐他汀胶囊20 mg/d＋阿司匹林肠溶片0.1 g/d＋降糖药，检测基线及入组后6月、12月、24月时的血浆hs-CRP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（IM T ）。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 peri-od ,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.