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目的:关注非糖尿病患者长期使用他汀类药物治疗与新发糖尿病的相关性,为临床安全合理用药提供参考。方法:采用病例回顾性研究,通过我院病历查询系统获取2003年1月-2013年4月期间在我院住院治疗过程中初次服用他汀类药物的住院患者。收集患者开始他汀类治疗后历次住院病历中的人口学资料、血糖及其他实验室检查、用药方案变化等数据,利用SPSS 19.0统计学软件进行危险因素筛选和显著性分析。结果:共纳入有效病例101例,发生新发糖尿病者6例(5.94%),男性5例(83.33%),女性1例(16.67%)。比较新发糖尿病组和未发生组的基线期情况,结果显示空腹血糖、总胆固醇和低密度脂蛋白水平在两组间有显著性差异(P<0.05)。将上述观察指标纳入Logistic回归分析,其中空腹血糖为新发糖尿病的影响因素。结论:长期服用他汀类药物可能引起新发糖尿病,对于基础空腹血糖水平较高的患者新发糖尿病风险更大。临床应用他汀类发生新发糖尿病时,应在保证他汀类疗效基础上做出对症处理。
Objective: To investigate the relationship between long-term statin therapy and new-onset diabetes in non-diabetic patients and to provide a reference for clinical safety and rational drug use. Methods: A retrospective case-by-case study was conducted to obtain inpatients who were taking a statin for the first time during hospitalization in our hospital from January 2003 to April 2013 through our medical records system. The demographic data, blood glucose and other laboratory tests, medication regimens and other data from previous hospital records were collected after statin therapy was started. Risk factors were screened and significance analyzed using SPSS 19.0 statistical software. Results: A total of 101 valid cases were included. Six cases (5.94%) had new-onset diabetes mellitus. There were 5 males (83.33%) and 1 females (16.67%). Compared with the baseline group of patients with newly diagnosed diabetes mellitus and those without diabetes, the fasting blood glucose, total cholesterol and low density lipoprotein levels were significantly different between the two groups (P <0.05). The above indexes were included in the logistic regression analysis, in which fasting blood glucose was the influencing factor of new-onset diabetes mellitus. CONCLUSION: Long-term statin use may cause new-onset diabetes and a greater risk of new-onset diabetes in patients with higher basal fasting plasma glucose levels. Clinical application of statins in the new onset of diabetes, should be based on the efficacy of statins to make symptomatic treatment.