厄贝沙坦对颈动脉粥样硬化合并2型糖尿病患者高敏C反应蛋白和胰岛素抵抗指数的影响

摘要

Objective To investigate the effects of irbesartan on serum high sensitivity C-reactive protein( hs-CRP) and insulin resistance index in patients with carotid atherosclerosis combining with type 2 diabetes. Methods Sixty patients with CAS(CAS combining T2DM group,30 cases;CAS uncombining T2DM group,30 cases) were treated with irbesartan 150 mg ? D-1 for two months. The level of serum hs-CRP and insulin resistance index were detected and compared with 30 healthy controls( normal control group) before and after treatment. The degree of CAS was determinded by carotid color doppler before and after treatment. Results Before and after treatment,hs-CRP levels in CAS combining T2DM group and CAS uncombining T2DM group were significantly higher than these in normal control group( P < 0.01). Compared with pre-treatment, hs-CRP levels in CAS combining T2DM group and CAS uncombining T2DM group were significantly lower after treatment/1 < 0.01). There was no significant difference in the level of hs-CRP between two groups before and after treatment (P > 0.05 ). Before and after treatment,fasting blood glucose! FBG) ,2 hours postprandial blood glucose(2hPBG) and insulin resistance index in CAS combining T2DM group were significantly higher than these in CAS uncombining T2DM and normal control groups (P<0. 01). Compared with pre-treatment,2hPBG and insulin resistance index in CAS combining T2DM group were significantly lower after treatment P <0.01). There was no significant difference in FBG in CAS combining T2DM group before and after treatment(P>0.05).There was no significant difference in FBG,2hPBG and insulin resistance index in CAS uncombining T2DM group before and after the treatment( P >0.05). Compared with pretreatment, the degrees of CAS descended significantly in CAS combining T2DM group and CAS uncombining T2DM group after treatmentP<0.01). There was no significant difference in the degrees of CAS in CAS combining T2DM group and CAS uncombining T2DM group before and after treatment (P>0.05). Conclusion Irbesartan can derease the level of serum hs-CRP,inhibit inflammatory reactions,improve insulin resistance and the CAS degree in patients with CAS combining T2DM.%目的 探讨厄贝沙坦对颈动脉粥样硬化(CAS)合并2型糖尿病(T2DM)患者血清高敏C反应蛋白(hs-CRP)及胰岛素抵抗指数的影响.方法 60例CAS患者(CAS合并T2DM组30例,CAS未合并T2DM组30例)给予厄贝沙坦150 mg·d-1,疗程2个月；检测治疗前后患者血清hs-CRP及胰岛素抵抗指数,并与30例健康体检者(正常对照组)比较；采用颈动脉超声多普勒检查治疗前后CAS程度.结果 治疗前、后CAS合并T2DM组和CAS未合并T2DM组血清hs-CRP水平均显著高于正常对照组(P ＜0.01)；CAS合并T2DM组和CAS未合并T2DM组治疗后血清hs-CRP水平均显著低于治疗前(P＜0.01)；治疗前、后CAS合并T2DM组与CAS未合并T2DM组血清hs-CRP水平比较差异均无统计学意义(P＞0.05).治疗前、后CAS合并T2DM组患者空腹血糖、餐后2h血糖和胰岛素抵抗指数均显著高于正常对照组和CAS未合并T2DM组(P＜0.01)；CAS合并T2DM组治疗后餐后2h血糖和胰岛素抵抗指数均显著低于治疗前(P＜0.01),但空腹血糖下降不明显(P＞0.05)；CAS未合并T2DM组治疗前、后空腹血糖、餐后2h血糖和胰岛素抵抗指数比较差异均无统计学意义(P＞0.05).CAS合并T2DM组和CAS未合并T2DM组患者治疗后CAS程度均较治疗前显著降低(P＜0.01)；治疗前、后2组间CAS程度比较差异均无统计学意义(P＞0.05).结论 厄贝沙坦可降低CAS合并T2DM患者血清hs-CRP水平,抑制炎症反应,改善胰岛素抵抗及CAS程度.