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目的探讨辛伐他汀对2型糖尿病(T2DM)合并动脉粥样硬化斑块性质及炎症因子水平的影响。方法选取解放军第91中心医院收治的168例T2DM患者为研究对象,按照治疗方式随机分为对照组(76例)与观察组(92例),其中对照组予以常规降糖、抗炎治疗,观察组在对照组用药基础上加用辛伐他汀,两组均治疗3个月,疗程结束后比较两组患者的颈动脉超声检查结果,包括内膜斑块面积、易损斑块例数及Crouse积分,同时检测炎性因子水平,包括白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及超敏C-反应蛋白(hs-CRP)。结果治疗后,两组患者颈动脉内膜中层厚度(IMT)、内膜斑块面积、Crouse总积分及易损斑块例数均显著低于治疗前,且观察组下降幅度显著小于对照组,差异均有统计学意义(P<0.05);两组患者血清炎症因子IL-6、TNF-α及hs-CRP均低于治疗前,且观察组下降幅度均显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论辛伐他汀可显著改善T2DM合并动脉粥样硬化患者颈动脉斑块性质,减小斑块面积、抑制炎性反应。
Objective To investigate the effect of simvastatin on the characteristics of atherosclerotic plaque and the level of inflammatory cytokines in type 2 diabetes mellitus (T2DM). Methods Totally 168 T2DM patients admitted to the 91st Central Hospital of PLA were enrolled in this study. The patients were randomly divided into control group (n = 76) and observation group (n = 92). The control group was given conventional hypoglycemic and anti- Groups were given simvastatin on the basis of the control group. Both groups were treated for 3 months. The results of carotid ultrasonography were compared between the two groups after the course of treatment, including the area of intima plaque, the number of vulnerable plaque and Crouse The levels of IL - 6, TNF - α and hs - CRP were detected at the same time. Results After treatment, carotid artery intima-media thickness (IMT), plaque area, Crouse score and vulnerable plaque in both groups were significantly lower than those before treatment, and the decrease in the observation group was significantly smaller than that in the control group. (P <0.05). Serum inflammatory cytokines IL-6, TNF-α and hs-CRP in both groups were lower than those before treatment, and the decreasing rates in observation group were significantly lower than those in control group The difference was statistically significant (P <0.05). Conclusion Simvastatin can significantly improve the carotid plaque characteristics, reduce plaque area and inhibit inflammatory reaction in T2DM patients with atherosclerosis.