目的 考察不同劑量辛伐他汀聯(lián)合非諾貝特膠囊治療2型糖尿病合并高脂血癥的臨床療效及安全性.方法 天津市第五中心醫(yī)院2010年6月—2014年4月收治的2型糖尿病合并高脂血癥患者110例,隨機(jī)分為高劑量組和低劑量組,每組55例.兩組患者均口服非諾貝特膠囊,1粒/次,3次/d.高劑量組口服辛伐他汀片40 mg/次,1次/d;低劑量組口服辛伐他汀片20 mg/次,1次/d.兩組均連續(xù)治療8周.比較兩組患者的血脂水平、血液安全指標(biāo)和不良反應(yīng)發(fā)生率.結(jié)果 治療后,兩組患者血脂水平均得到顯著改善,其中,總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)較治療前顯著降低,且高密度脂蛋白膽固醇(HDL-C)較治療前顯著升高,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05).治療后,高劑量組患者的丙氨酸氨基轉(zhuǎn)氨酶(ALT)、血尿素氮(BUN)及肌酐(Cr)均較治療前顯著升高,而低劑量組BUN較治療前降低,Cr較治療前升高,同組治療前后差異均有統(tǒng)計(jì)學(xué)意義(P<0.05);治療后,低劑量組ALT、BUN、Cr水平低于高劑量組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05、0.01).高、低劑量組不良反應(yīng)發(fā)生率分別為9.09%、7.27%,兩組不良反應(yīng)發(fā)生率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05).結(jié)論 低劑量辛伐他汀聯(lián)合非諾貝特治療2型糖尿病合并高脂血癥具有較好的臨床療效,可較好地控制患者血脂水平,并降低患者腎臟代謝負(fù)擔(dān)和不良反應(yīng)發(fā)生率.

Objective To investigate the clinical efficacy and safety of simvastatin with different doses combined with fenofibrate in treatment of type 2 diabetes complicated with hyperlipidemia. Methods Patientswith type 2 diabetes complicated with hyperlipidemia from June 2010 to April 2014 (110 cases) were randomly divided into high dose and low dose groups (n = 55). Patients in two groups were po administered with Fenofibrate Capsules, 1 grain/time, three times daily. Patients in high dose group were po administered with Simvastatin Tablets, 40 mg/time, once daily, while patients in low dose group were po administered with Simvastatin Tablets, 20 mg/time, once daily. The patients in the two groups were treated for 8 weeks. The levels of blood lipid, indexes of blood safety and incidence of adverse reactions in two groups were compared. Results After treatment, levels of blood lipid in two groups were improved significantly, and TC, TG, and LDL-C were significantly reduced, while HDL-C was significantly higher, and the difference was statistically significant before and after the treatment in the same group (P < 0.05). After treatment, ALT, BUN, and Cr of high dose group were significantly higher, while BUN of low dose group was lower and Cr was higher, and the difference was statistically significant before and after the treatment in the same group (P < 0.05). After treatment, ALT, BUN, and Cr in low dose group were lower than those in the high dose group, and there were differences between the two groups (P < 0.05, 0.01). Incidence of adverse reactions in high and low dose group were 9.09% and 7.27%, respectively, and there were differences between the two groups (P < 0.05). Conclusion Low dose of simvastatin combined with fenofibrate has a good clinical effect in treatment of type 2 be better control levels of blood lipid, which can reduce the metabolism burden of kidney and the incidence of adverse reactions.

國(guó)家自然科學(xué)基金資助項(xiàng)目(81000356)