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目的:探讨辛伐他汀治疗对Ⅱ型糖尿病(T2DM)合并肾病患者糖代谢水平的影响。方法:选取新乡医学院第一附属医院60名T2DM合并肾病患者行辛伐他汀治疗3个月。比较治疗前后空腹血糖(FBG)、游离脂肪酸(FFA)、脂联素(ANP)、C肽、HOMA-IR、胰岛素/葡萄糖比率(IGR)、胰岛素敏感指数(ISI)、空腹胰岛素水平(FINS)、C反应蛋白(CRP)、糖基化血红蛋白(HbA1c)水平等变化,以评价辛伐他汀对T2DM病合并肾病患者的治疗效果。结果:在辛伐他汀治疗3个月后的葡萄糖耐量试验(OGTT)中,对比治疗前,各时点血糖水平均显著下降(P<0.05),而C肽与胰岛素在0 min和30 min时显著下降(P<0.05)。在辛伐他汀治疗后,HO-MA-IR、游离脂肪酸(FFA)、ISI、FINS、胰岛素AUC、血糖曲线下面积(AUC)、CRP、HbA1c、FBG与治疗前相比均显著下降(P<0.05),尿白蛋白排泄率(UAER)也明显下降(P<0.01),但是APN(P<0.01)以及C肽AUC(P<0.05)均显著上升,而校正胰岛素反应(CIR)及IGR无显著变化(P>0.05)。结论:辛伐他汀治疗可以改善胰岛素抵抗,提高患者对胰岛素的敏感性,并显著降低血糖,从而改善T2DM合并肾病患者的糖代谢。
Objective: To investigate the effect of simvastatin on glycometabolism in patients with type 2 diabetes mellitus (T2DM) with nephropathy. Methods: 60 patients with T2DM with nephropathy in the First Affiliated Hospital of Xinxiang Medical College were treated with simvastatin for 3 months. Fasting blood glucose (FBG), free fatty acids (FFA), adiponectin (ANP), C peptide, HOMA-IR, insulin / glucose ratio (IGR), insulin sensitivity index (ISI) and fasting insulin (FINS) , CRP and HbA1c were measured to evaluate the effect of simvastatin on T2DM patients with nephropathy. Results: In the glucose tolerance test (OGTT) 3 months after simvastatin treatment, blood glucose levels were significantly decreased (P <0.05) at all time points before treatment and at 0 and 30 minutes Significantly decreased (P <0.05). The levels of HO-MA-IR, FFA, ISI, FINS, insulin AUC, AUC, CRP, HbA1c and FBG decreased significantly after simvastatin treatment (P < 0.05) and urinary albumin excretion rate (UAER) also decreased significantly (P <0.01), but both APN (P <0.01) and C peptide AUC Significant changes (P> 0.05). CONCLUSIONS: Simvastatin treatment improves insulin resistance, increases insulin sensitivity in patients, and significantly reduces blood glucose, thus improving glycometabolism in T2DM patients with nephropathy.