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目的观察辛伐他汀对2型糖尿病患者血管内皮功能及炎症因子的影响。方法选择30例2型糖尿病(T2DM)患者及25例对照者,给予辛伐他汀20mg/d治疗12个月。分别于治疗前、治疗1个月及12个月时,检测肱动脉血流介导性扩张,并测定主要血脂参数、超敏C反应蛋白(hsCRP)、空腹血糖(FPG)、胰岛素(FIns)和胰岛素抵抗指数(HOMA-IR)。结果①辛伐他汀治疗可明显改善T2DM组及对照组患者血脂水平。②辛伐他汀治疗1个月后,T2DM组患者肱动脉内皮依赖性舒张功能(FMD)较治疗前无明显变化[(5.94±0.87)%vs.(5.65±0.65)%,P﹥0.05],治疗12个月后,FMD虽有上升趋势[(6.10±0.71)%],但仍无显著性差异。辛伐他汀可明显改善对照组的FMD。③治疗12个月时T2DM组患者血清hs-CRP水平由(15.21±3.71)mg/L降至(10.51±2.90)mg/L(P﹤0.01)。④辛伐他汀对T2DM患者FPG、FIns及HOMA-IR均无影响。结论辛伐他汀治疗12个月,尽管可以显著降低T2DM患者血脂水平,减轻炎症反应,但受损的血管内皮功能并未得到改善。
Objective To observe the effect of simvastatin on vascular endothelial function and inflammatory factors in type 2 diabetic patients. Methods Thirty patients with type 2 diabetes mellitus (T2DM) and 25 controls were enrolled. Simvastatin 20 mg / d was given for 12 months. Blood flow-mediated dilatation of the brachial artery was measured before treatment, at 1 month and at 12 months of treatment, and the levels of major lipid parameters, hsCRP, FPG, FIns, And insulin resistance index (HOMA-IR). Results ① Simvastatin treatment significantly improved blood lipid levels in T2DM and control groups. ② After 1 month of simvastatin treatment, the endothelium-dependent relaxation function (FMD) of brachial artery in T2DM group had no significant change compared with that before treatment [(5.94 ± 0.87)% vs (5.65 ± 0.65)%, P> 0.05] After 12 months of treatment, although there was an upward trend in FMD [(6.10 ± 0.71)%], there was no significant difference. Simvastatin significantly improved FMD in the control group. ③ The level of hs-CRP in T2DM patients decreased from (15.21 ± 3.71) mg / L to (10.51 ± 2.90) mg / L at 12 months after treatment (P <0.01). Simvastatin had no effect on FPG, FIns and HOMA-IR in T2DM patients. Conclusion Simvastatin treatment for 12 months, although it can significantly reduce the level of blood lipid in patients with T2DM, reduce the inflammatory response, but the damaged vascular endothelial function has not been improved.