2019 年第 2 期 第 14 卷

不同品种他汀类药物对非糖尿病冠状动脉粥样硬化性心脏病患者糖代谢的影响

Effect of different statins on glycometabolism in patients with non-diabetic coronary atherosclerotic heart disease

作者：刘思宁田学峰王政徐梦

英文作者：

单位：150060哈尔滨，黑龙江省医院心血管内科

英文单位：

关键词：冠状动脉粥样硬化性心脏病；阿托伐他汀；瑞舒伐他汀；匹伐他汀；糖代谢

英文关键词：

• 摘要：

• 【摘要】目的    研究不同品种他汀类药物对非糖尿病冠状动脉粥样硬化性心脏病（冠心病）患者糖代谢的影响，为临床合理应用提供参考。方法    收集黑龙江省医院2013年1月至2017年6月诊治的非糖尿病冠心病患者的临床资料，按照服用药物的不同分为阿托伐他汀组（服用阿托伐他汀钙片，20 mg/d）、瑞舒伐他汀组（服用瑞舒伐他汀钙片，10 mg/d）和匹伐他汀组（服用匹伐他汀钙片，2 mg/d），各60例。分析各组研究对象治疗前及治疗后4周及治疗后12周血脂及糖代谢指标的变化情况。结果    与治疗前比较，治疗后4周及12周3组三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平均明显降低，而高密度脂蛋白胆固醇水平均明显升高，差异均有统计学意义（均P<0.05）。与治疗前比较，治疗后12周阿托伐他汀组、瑞舒伐他汀组空腹血糖、糖化血红蛋白水平升高，空腹胰岛素水平降低［阿托伐他汀组：（5.9±0.9）mmol/L比（5.4±0.9）mmol/L、（6.7±0.8）%比（6.4±0.5）%、（8.1±0.8）mIU/L比（8.6±0.9）mIU/L；瑞舒伐他汀组：（5.8±0.9）mmol/L比（5.4±1.0）mmol/L、（6.7±0.8）%比（6.4±0.9）%、（8.1±0.8）mIU/L比（8.5±0.8）mIU/L］，差异均有统计学意义（均P<0.05）。结论    匹伐他汀对非糖尿病冠心病患者糖代谢影响较小，不增加冠心病患者新发糖尿病风险。

• 【Abstract】Objective    To investigate the effect of different statins on glycometabolism in patients with non-diabetic coronary atherosclerotic heart disease（CHD）. Methods    Clinical data of patients with non-diabetic CHD admitted to Heilongjiang Provincial Hospital from January 2013 to June 2017 were retrospectively analyzed. The patients were divided into atorvastatin group（20 mg/d）, rosuvastatin group（10 mg/d） and pitavastatin group（2 mg/d）, with 60 cases in each group. Changes of blood lipids and glycometabolism indexes were analyzed before, 4 and 12 weeks after treatment. Results    Levels of serum triglyceride, total cholesterol and low density lipoprotein cholesterol in the three group significantly decreased and high density lipoprotein cholesterol level significantly increased 4 and 12 weeks after treatment(all P<0.05); there was no significant difference among the three groups(P>0.05). After 12 weeks of treatment, serum levels of fasting blood glucose and glycosylated hemoglobin significantly increased and fasting insulin significantly decreased compared to those before treatment in the atorvastatin group and rosuvastatin group［atorvastatin group:（5.9±0.9）mmol/L vs （5.4±0.9）mmol/L, （6.7±0.8）% vs （6.4±0.5）%, （8.1±0.8）mIU/L vs （8.6±0.9）mIU/L; rosuvastatin group:（5.8±0.9）mmol/L vs （5.4±1.0）mmol/L, （6.7±0.8）% vs （6.4±0.9）%, （8.1±0.8）mIU/L vs （8.2±0.8）mIU/L］(all P<0.05). Conclusion    Pitavastatin shows no obvious effect on glycometabolism in patients with non-diabetic CHD and does not increase the risk of newly onset diabetes in patients with CHD.