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动脉粥样硬化性心血管疾病是糖尿病最常见的并发症,而患者高密度脂蛋白(high density lipoprotein,HDL)水平和功能是影响AS发生发展的重要指标之一。本文旨在探讨吡格列酮与瑞舒伐他汀钙联合治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)患者HDL的改善作用,以期在临床上预测该治疗措施对糖尿病并发症的防治效果。将70例T2DM患者,按年龄、性别、病情、药物基本匹配的原则,分为对照组和吡格列酮组,每组35人,两组患者除常规使用胰岛素降糖治疗外,对照组给予瑞舒伐他汀钙片,吡格列酮组给予瑞舒伐他汀钙片及盐酸吡格列酮片,治疗3个月后临床观察患者空腹血糖(fasting blood sugar,FPG)、餐后血糖(post-prandial glycaemia,PPG)、糖化血红蛋白(glycated hemoglobin,Hb A1c)、甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)水平,同时提取患者HDL,检测不同药物治疗对HDL功能的改善效果。与治疗前相比,吡格列酮组患者FPG、PPG、Hb A1c、TC、TG及LDL-C均明显下降,HDLC水平明显升高;治疗后组间比较显示:与对照组相比,吡格列酮干预后患者HDL-C水平升高10.67%。HDL功能检测显示:药物治疗3月后,与对照组相比,吡格列酮组患者HDL介导细胞胆固醇外排效率增加25%,并使细胞内相关转运蛋白ATP结合盒转运体A1(ATP-binding cassette transporter A1,ABCA1)表达增加;同时,吡格列酮组患者HDL抗巨噬细胞凋亡功能亦明显提高。在2型糖尿病治疗中,吡格列酮联合瑞舒伐他汀钙不仅可以稳定血糖、血脂水平,而且可以升高HDL水平,改善HDL的功能,对于延缓T2DM患者出现心血管并发症具有重要意义。
Atherosclerotic cardiovascular disease is the most common complication of diabetes mellitus, and the level and function of HDL in patients is one of the important indexes that affect the occurrence and development of AS. This article aims to explore the effect of pioglitazone combined with rosuvastatin calcium on HDL in patients with type 2 diabetes mellitus (T2DM), in order to predict the clinical effect of this treatment on the prevention and treatment of diabetic complications. Seventy patients with T2DM were divided into control group and pioglitazone group according to the principle of age, gender, disease and drug matching. Each group had 35 patients. In both groups, except insulin routine glucose lowering therapy, the control group was given rosuvastatin Statin calcium and pioglitazone groups were given rosuvastatin calcium tablets and pioglitazone hydrochloride tablets. After 3 months of treatment, fasting blood sugar (FPG), post-prandial glycaemia (PPG), glycosylated hemoglobin Glycated hemoglobin (Hb A1c), triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein cholesterol density lipoprotein-cholesterol (LDL-C) levels, meanwhile HDL was extracted from the patients to detect the effect of different drugs on HDL function. The levels of FPG, PPG, Hb A1c, TC, TG and LDL-C in pioglitazone group were significantly decreased and the level of HDLC was significantly increased in the pioglitazone group compared with that before treatment. Compared with the control group, the patients with pioglitazone intervention HDL-C levels increased by 10.67%. HDL function tests showed that after 3 months of drug treatment, the HDL-mediated cytokine efflux efficiency by HDL increased by 25% in the pioglitazone group compared with the control group, and the intracellular transport protein ATP-binding cassette A1 transporter A1 and ABCA1). At the same time, HDL anti-macrophage apoptosis function in pioglitazone group was also significantly increased. In the treatment of type 2 diabetes, pioglitazone combined with rosuvastatin calcium can not only stabilize blood glucose and blood lipid levels, but also raise the level of HDL and improve the function of HDL, which is of great significance for delaying the occurrence of cardiovascular complications in T2DM patients.