不同剂量他汀类药物对冠心病患者糖调节机制的影响

发布时间：2018-03-10 12:46

本文选题：他汀类药物　切入点：冠心病　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:他汀类药物在上市后的监测中发现其可引起血糖水平异常、新发糖尿病、糖尿病恶化等不良反应。故本研究通过不同剂量阿托伐他汀治疗冠心病合并血脂异常的患者,观察这些患者血糖、胰岛β细胞早期分泌功能及胰岛素的敏感性是否产生改变,是否产生药物不良反应,为冠心病合并血脂异常的患者进行药物干预治疗过程中的安全性提供临床依据。方法:筛选2015年11月--2016年11月在青海省人民医院心血管科住院经冠脉造影术明确诊断为冠心病的其中合并高脂血症的患者110例,平均年龄60.9±9.6岁,男女不限;根据入选者的TC、LDL-C(依据《中国成人血脂异常防治指南》[1])及服药情况(阿托伐他汀钙片、规格20mg/片,辉瑞制药有限公司,批号:国药准字H20051408)分为2组。10mg组:55例,患者TC 5.18~6.19mmol/L、LDL-C 3.37~4.12mmol/L,口服阿托伐他汀10mg;20mg组:55例,患者TC6.19mmol/L、LDL-C4.12mmol/L,口服阿托伐他汀20mg。分别于服药前1天及服药1月后检测患者血清TC、LDL-C、TG、FBG、FINS、糖负荷30min血糖、胰岛素、HbAlc、胰岛素抵抗指数及胰岛素分泌指数等指标。两组之间患者在年龄、性别、体重三方面相比较,差异无统计学意义。结果:两组患者服药后TC、LDL-C、TG这些指标与服药前进行比较明显降低,差异均有统计学意义(P0.05)。两组患者服药后FBG、FINS、糖负荷30min血糖及胰岛素、胰岛素分泌指数、HbAlc这些指标与服药前进行比较未见明显改变,差异均无统计学意义(P0.05)。两组受试者服药后胰岛素抵抗指数与服药前进行比较明显升高,差异有统计学意义(P0.05)。服药后10mg组与20mg组两组之间进行比较,FBG、FINS、糖负荷30min血糖及胰岛素、胰岛素抵抗指数、胰岛素分泌指数、TC、LDL-C、TG、HbAlc这些指标比较未见明显改变,差异均无统计学意义(P0.05)。结论:1、短期内服用不同剂量他汀类药物对冠心病患者血糖及胰岛素分泌无明显影响;2、短期内他汀类药物对冠心病患者糖调节机制的影响主要为增强胰岛素抵抗。
[Abstract]:Objective: it was found that statins can cause abnormal blood glucose level, newly developed diabetes mellitus, worsening diabetes mellitus and other adverse reactions during postmarketing monitoring. Therefore, different doses of Atto vastatin were used to treat patients with coronary heart disease complicated with dyslipidemia. Whether blood sugar, early secretion function of islet 尾 cells, insulin sensitivity and adverse drug reactions were changed in these patients were observed. To provide clinical evidence for the safety of patients with coronary heart disease complicated with dyslipidemia during the course of drug intervention. Methods: to select the inpatients with coronary angiography in the Department of Cardiovascular Medicine of Qinghai Provincial people's Hospital from November 2015 to November 2016. Among them, 110 patients with hyperlipidemia were diagnosed as coronary heart disease. The average age was 60.9 卤9.6 years old, male and female were not limited, according to the TCU LDL-C (according to the guidelines for the Prevention and treatment of Adult dyslipidemia in China [1]) and the medication (Atto vastatin calcium tablets, 20mg / tablet, Pfizer Pharmaceutical Co., Ltd.), Batch number: H20051408) divided into two groups: 10 mg group: 55 cases, TC 5.18 卤6.19 mmol / L LDL-C 3.37 mg / L 4.12 mmol / L, oral Atto vastatin 10 mg / L 20 mg group 55 cases, TC6.19 mmol / L LDL-C4.12 mmol / L, and Atto vastatin 20 mg 路min. HbAlc, insulin resistance index and insulin secretion index were compared between the two groups in age, sex and weight. Results: the levels of TCnLDL-CTG were significantly lower in the two groups than before, and the difference was statistically significant (P 0.05). FBGN FINS, glucose load for 30 min and insulin, were observed in the two groups. The insulin secretion index and HbAlc were not significantly changed compared with those before administration, and the differences were not statistically significant (P 0.05). The insulin resistance index of the two groups was significantly higher than that before administration. The difference was statistically significant (P 0.05). There was no significant change in FBGN FINS, glucose, insulin, insulin resistance index, insulin secretion index and TCU LDL-C HbAlc between 10 mg group and 20 mg group. Conclusion different doses of statins have no significant effect on blood glucose and insulin secretion in patients with coronary heart disease (CHD) in a short period of time. In the short term, statins affect the mechanism of glucose regulation in patients with coronary heart disease. To enhance insulin resistance.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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