詹婧,李丹,黄燕
ZHAN Jing,LI Dan,HUANG Yan

• 1:自贡市第一人民医院药剂科
• 2:自贡市第一人民医院心内科
• 3:四川省妇幼保健院

摘要(Abstract)：

目的 探究不同剂量瑞舒伐他汀应用于急性冠脉综合征(ACS)合并2型糖尿病(T2DM)的治疗效果。方法 选取ACS合并T2DM患者156例，按照随机数字表法随机均分为观察组和对照组，对照组给予常规药物瑞舒伐他汀治疗(剂量为10 mg/晚),观察组在对照组常规治疗基础上给予瑞舒伐他汀治疗(剂量为20 mg/晚);于服药前、服药后4周时检测两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及肌酐水平，统计患者血脂达标率，并计算肾小球滤过率(eGFR);于服药前，服药后1周、2周、4周时，应用酶联免疫吸附法测定血管细胞黏附分子1(VCAM-1)、细胞间黏附分子1(ICAM-1)和凝血酶原激活物抑制物(PAI-1)水平；治疗后定期随访12周，记录两组患者心肾不良事件并发症发生情况。结果 两组患者服药前血脂水平比较，差异无统计学意义(P>0.05),治疗后4周时，观察组TC、TG、LDL-C水平均低于对照组，观察组血脂达标率高于对照组，差异有统计学意义(P<0.05);两组患者服药后4周时，eGFR水平较服药前降低，差异有统计学意义(P<0.05);服药前与服药后4周时，两组患者eGFR水平比较，差异均无统计学意义(P>0.05);服药后1周、2周、4周时，观察组VCAM-1、ICAM-1、PAI-1水平均低于对照组，差异有统计学意义(P<0.05);观察组心肾不良事件并发症总发生率低于对照组，差异有统计学意义(P<0.05)。结论 20 mg剂量瑞舒伐他汀相较于10 mg用药治疗ACS合并T2DM可提高血脂达标率，减少心肾不良事件发生。
Objective To investigate the efficacy and safety of different doses of rosuvastatin in the treatment of acute coronary syndrome(ACS) combined with type 2 diabetes mellitus(T2DM). Methods A total of 156 patients with ACS combined with T2DM were selected and randomly divided into the observation group and the control group based on the random number table, with 78 cases in each group. Both groups were given conventional drug therapy, and the observation group was additionally given rosuvastatin, 20 mg/night; The control group was given rosuvastatin, 10 mg/night. The levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), and creatinine in 2 groups were detected before and 4 weeks after medication. The standard rate of blood lipid and glomerular filtration rate(eGFR) were calculated. The levels of vascular cell adhesion molecule 1(VCAM-1), intercellular adhesion molecule 1(ICAM-1), and prothrombin activator inhibitor(PAI-1) were determined by enzyme-linked immunosorbent assay before and 1 week, 2 weeks, and 4 weeks after medication. After treatment, the patients were followed up regularly for 12 weeks, and the incidence of cardiac and renal adverse events were recorded in both groups. Results There was no significant difference in blood lipid levels between the two groups before taking the medicine(P>0.05). After 4 weeks of treatment, the levels of TC, TG, and LDL-C in the observation group were significantly lower than those in the control group(P<0.05), while the blood lipid compliance rate(55.13% vs. 30.77%) was significantly higher than the control group(P<0.05). The eGFR levels of the two groups were significantly lower than those before the medication for 4 weeks, and the difference was statistically significant(P<0.05); there was no statistically significant difference in the eGFR levels between the two groups before and after the medication for 4 weeks(P>0.05).Before taking the medicine, there was no significant difference in the levels of VCAM-1, ICAM-1, and PAI-1 between the two groups(P>0.05); after taking the medicine for 1 week, 2 weeks, and 4 weeks, the observation group's indicators were significantly lower than those of the control group. All were statistically significant(all P<0.05). The total incidence of heart and kidney adverse events in the observation group(7.69% vs. 19.23%) was significantly lower than that in the control group(P<0.05). Conclusion Compared with 10 mg rosuvastatin in the treatment of ACS combined with T2DM, 20 mg rosuvastatin can increase the blood lipid compliance rate and reduce the incidence of cardiovascular and renal adverse events.

关键词(KeyWords)： 急性冠脉综合征;2型糖尿病;瑞舒伐他汀;肾小球滤过率
acute coronary syndrome;type 2 diabetes mellitus;rosuvastatin;glomerular filtration rate

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生厅科研课题项目(110070)

作者(Author): 詹婧,李丹,黄燕
ZHAN Jing,LI Dan,HUANG Yan

DOI: 10.19367/j.cnki.2096-8388.2023.07.018

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