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目的 观察氟伐他汀和辛伐他汀调脂外作用。方法 将 81例原发性高脂血症患者分为氟伐他汀组( 2 0 mg/ d持续 12周 ,n=5 6,继以 40 m g/ d至 2 4周 ,n=47)及辛伐他汀组 ( 10 m g/ d持续 12周 ,n=2 5 )。分析治疗前后空腹血浆胰岛素 ( FINS)、胰岛素敏感性指数 ( ISI)、血浆内皮素 ( ET- 1)、一氧化氮 ( NO)及 C-反应蛋白 ( CRP)平均变化幅度。结果 氟伐他汀治疗 12周及 2 4周后、辛伐他汀治疗 12周后 ,ET- 1及 FINS水平均有明显降低 ( P=0 .0 0 0～ 0 .0 3 2 ) ,ISI及 NO水平均有明显增高 ( P=0 .0 0 1～ 0 .0 42 )。前述各指标变化幅度组间对比差别均无显著性 ( P>0 .0 5 )。氟伐他汀治疗 12周及 2 4周后 ,CRP水平轻度下降 ( P>0 .0 5 ) ,辛伐他汀治疗 12周后 CRP水平轻度上升 ( P>0 .0 5 )。结论 氟伐他汀和辛伐他汀治疗均能增高胰岛素敏感性 ,改善胰岛素抵抗状态 ,改善内皮功能。这些调脂外作用与调脂治疗强度无关
Objective To observe the effects of fluvastatin and simvastatin on lipid metabolism. Methods 81 patients with primary hyperlipidemia were divided into fluvastatin group (20 mg / d for 12 weeks, n = 56, followed by 40 mg / d to 24 weeks, n = 47) In the statin group (10 mg / d for 12 weeks, n = 25). The changes of fasting plasma insulin (FINS), insulin sensitivity index (ISI), plasma endothelin (ET-1), nitric oxide (NO) and C-reactive protein (CRP) were analyzed before and after treatment. Results After 12 weeks and 24 weeks of treatment with fluvastatin, the levels of ET-1 and FINS in simvastatin group decreased significantly (P = 0.0000-0.0330), ISI and NO The levels were significantly higher (P = 0.010 ~ 0.042). There was no significant difference between the above groups (P> 0.05). After 12 weeks and 24 weeks of treatment with fluvastatin, the level of CRP decreased slightly (P> 0.05) and the level of CRP increased slightly after 12 weeks of simvastatin treatment (P> 0.05). Conclusion Both fluvastatin and simvastatin can increase insulin sensitivity, improve insulin resistance and improve endothelial function. These lipid-lowering effects have nothing to do with the strength of lipid-lowering treatment