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目的 :探讨依折麦布联合阿托伐他汀(10 mg/d+10 mg/d)与阿托伐他汀(20 mg/d)单药治疗对2型糖尿病患者ApoB/ApoA1的影响。方法 :90例2型糖尿病合并血脂异常患者[低密度脂蛋白胆固醇(LDL-C)>2.6 mmol/L]随机分为2组:联合组42例,在常规治疗基础上服用依折麦布和阿托伐他汀各10 mg/d;他汀组48例,在常规治疗基础上服用阿托伐他汀20 mg/d,共12周。观察2组患者治疗前后的ApoB/ApoA1、血脂、血糖水平变化及不良反应。结果 :治疗12周后,只有联合组ApoB/ApoA1值较治疗前显著降低(P<0.01);两组LDL-C、总胆固醇(TC)、甘油三酯(TG)均较治疗前显著降低(P<0.01),且联合组较他汀组下降更明显(P<0.05);两组高密度脂蛋白胆固醇(HDL-C)均较治疗前升高,但组间差异无统计学意义。治疗前后两组空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、血肌酐(Scr)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)无明显变化。结论:依折麦布联合阿托伐他汀能够更好地改善2型糖尿病患者的血脂谱,可能较他汀单药治疗更有效降低患者发生心血管并发症的风险。
Objective: To investigate the effects of ezetimibe combined with atorvastatin (10 mg / d + 10 mg / d) and atorvastatin (20 mg / d) on ApoB / ApoA1 in type 2 diabetic patients. Methods: Ninety patients with type 2 diabetes with dyslipidemia [LDL-C> 2.6 mmol / L] were randomly divided into two groups: 42 in combination group, taking ezetimibe and Atorvastatin each 10 mg / d; statin group 48 patients, on the basis of routine treatment with atorvastatin 20 mg / d for 12 weeks. ApoB / ApoA1, blood lipid, blood glucose levels and adverse reactions before and after treatment were observed in two groups. Results: After 12 weeks of treatment, only ApoB / ApoA1 in combination group was significantly lower than that before treatment (P <0.01); LDL-C, TC and triglyceride in both groups were significantly lower than those before treatment P <0.01), and the combined group was significantly lower than the statin group (P <0.05). The levels of HDL-C in both groups were higher than those before treatment, but there was no significant difference between the two groups. The levels of fasting blood glucose (FPG), Hb A1c, Scr, ALT, CK and creatine kinase (CK) No significant changes. Conclusion: Ezetimibe plus atorvastatin can improve the lipid profile of type 2 diabetic patients more effectively and may reduce the risk of cardiovascular complications more effectively than statin monotherapy.