阿托伐他汀对腔隙性脑梗死患者血糖代谢的影响及相关研究

发布时间：2018-09-06 16:19

【摘要】：目的:探讨阿托伐他汀对腔隙性脑梗死患者血糖代谢的影响,并对其进行药效及安全性分析,观察它对LDL-C/HDL-C的作用。方法:采用回顾性病例分析的研究方法,通过我院电子病历查询系统筛选自2013年1月1日至2016年12月31日在我院住院的腔隙性脑梗死患者的基本信息,收集其基线值和历次随诊的相关资料,主要指标包括空腹血糖、糖化血红蛋白、餐后2h血糖、血脂四项、肝功能、肾功能、肌酸激酶等。根据患者服用阿托伐他汀的时间(t)长短分为3个随访组,分别为随访组1(0t≤6个月)、随访组2(6t≤12个月)、随访组3(t12个月);此外,按照年龄段划分将各随访组中的随访对象分为中年组(40-65岁)和老年组(66岁以上),通过运用SPSS17.0统计学软件对基线值和终末值指标进行比较,观察阿托伐他汀(20mg/d)对腔隙性脑梗死患者的空腹血糖、糖化血红蛋白有无影响,对低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(LDL-C/HDL-C)有何作用,并对阿托伐他汀的药效及安全性进行分析。结果:纳入腔隙性脑梗死患者共156例,随访终末期发生1例新发糖尿病,而各随访组的前后对比以及中年组和老年组间对比,空腹血糖、糖化血红蛋白均无差异性改变,但老年组的糖化血红蛋白随着服用阿托伐他汀的时间的延长有升高的趋势。各随访组终末期的血清总胆固醇(TC)及低密度脂蛋胆固醇水平(LDL-C)较基线值明显降低,HDL-C水平较基线值轻度升高,前两者前后差异具有显著统计学意义,各随访组终末期LDL-C/HDL-C比值较基线期下降,且服用阿托伐他汀的时间越长,该比值有降低的趋势。随访终末期发生肝酶升高共3人,占1.92%,肌酶升高共2人,占1.28%,均未出现肌肉疼痛、腹泻、恶心等不良反应,亦无多饮、多食、多尿、明显消瘦等症状。结论:阿托伐他汀对腔隙性脑梗死患者的空腹血糖、糖化血红蛋白无明显影响,但其随着服用时间的延长具有升高老年人糖化血红蛋白的风险,老年人在长期服用他汀时需注意监测血糖代谢相关指标的变化;阿托伐他汀可降低腔隙性脑梗死患者的LDL-C/HDL-C的比值,具有良好的降脂作用及安全性。
[Abstract]:Aim: to investigate the effect of Atto vastatin on blood glucose metabolism in patients with lacunar cerebral infarction, and to analyze its efficacy and safety, and to observe its effect on LDL-C/HDL-C. Methods: the basic information of patients with lacunar cerebral infarction who were hospitalized in our hospital from January 1, 2013 to December 31, 2016 was screened through the electronic medical record query system of our hospital by retrospective case analysis. The baseline values and previous follow-up data were collected, including fasting blood glucose, glycosylated hemoglobin, 2 h postprandial blood glucose, four items of blood lipids, liver function, renal function, creatine kinase and so on. According to the duration of (t), the patients were divided into three follow-up groups: group 1 (0 t 鈮，

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