CAJ | 학술논문

目的：前瞻性观察瑞舒伐他汀钙对老年2型糖尿病（Type 2 Diabetes Mellitus ，T2DM ）合并缺血性脑卒中患者颈动脉硬化、血脂、hs-CRP的疗效，为老年T2DM合并缺血性脑卒中的二级预防提供更多的临床证据。方法将我院老年T2DM 合并急性ICVD患者226例，随机分成2组：（1）治疗组：瑞舒伐他汀钙片5 mg/d ＋阿司匹林肠溶片0.1 g/d＋降糖药；（2）对照组：洛伐他汀胶囊20 mg/d＋阿司匹林肠溶片0.1 g/d＋降糖药，检测基线及入组后6月、12月、24月时的血浆hs-CRP和血脂等各项指标，同时做颈动脉彩色多普勒超声检测基线及入组后6月、12月、24月时颈动脉内-中膜厚度（IM T ）。结果在入组后6月、12月、24月时，治疗组的血浆hs-CRP和血脂水平低于对照组（P＜0.05）；2组在入组后6月、12月、24月时，2组的颈动脉彩色多普勒超声检测指标均优于入院时的基线水平，有显著性差异和极显著性差异（P＜0.05，P＜0.01）；在入组后12月、24月时治疗组的超声检测指标优于对照组，有显著性差异和极显著性差异（ P＜0.05，P＜0.01）。结论瑞舒伐他汀钙片可显著降低老年T2DM合并缺血性脑卒中患者的血脂、hs-CRP ，并有逆转颈动脉粥样硬化斑块的作用，且疗效明显优于洛伐他汀胶囊，为老年T2DM合并急性ICVD的防治提供理论依据。
목적：전첨성관찰서서벌타정개대노년2형당뇨병（Type 2 Diabetes Mellitus ，T2DM ）합병결혈성뇌졸중환자경동맥경화、혈지、hs-CRP적료효，위노년T2DM합병결혈성뇌졸중적이급예방제공경다적림상증거。방법장아원노년T2DM 합병급성ICVD환자226례，수궤분성2조：（1）치료조：서서벌타정개편5 mg/d ＋아사필림장용편0.1 g/d＋강당약；（2）대조조：락벌타정효낭20 mg/d＋아사필림장용편0.1 g/d＋강당약，검측기선급입조후6월、12월、24월시적혈장hs-CRP화혈지등각항지표，동시주경동맥채색다보륵초성검측기선급입조후6월、12월、24월시경동맥내-중막후도（IM T ）。결과재입조후6월、12월、24월시，치료조적혈장hs-CRP화혈지수평저우대조조（P＜0.05）；2조재입조후6월、12월、24월시，2조적경동맥채색다보륵초성검측지표균우우입원시적기선수평，유현저성차이화겁현저성차이（P＜0.05，P＜0.01）；재입조후12월、24월시치료조적초성검측지표우우대조조，유현저성차이화겁현저성차이（ P＜0.05，P＜0.01）。결론서서벌타정개편가현저강저노년T2DM합병결혈성뇌졸중환자적혈지、hs-CRP ，병유역전경동맥죽양경화반괴적작용，차료효명현우우락벌타정효낭，위노년T2DM합병급성ICVD적방치제공이론의거。
Objective To prospectively study of the effect of rosuvastatin on carotid atherosclerotic plaques ,lipid and high-sensitivity CRP (hs-CRP) in patients with elderly type 2 diabetic and ischemic stroke ,and to provide evidence for clinical practice on the secondary prevention of stroke.Methods Two hundred and twenty-six cases of elderly type 2 diabetes mellitus (T2DM ) and acute ICVD from the hospitalized patients were randomly divided into two groups :(1)the treatment group ,108 cases received the treatment of rosuvastatin 5 mg (qn) + aspirin 100 mg (qd) and antidiabetic drug ;(2) the control group , 113 cases received the treatment of luofastatin 20 mg (qn) + aspirin 100 mg (qd) and antidiabetic drug.The serum levels of hs-CRP and lipids of all patients were measured before and 6 months ,12 months and 24 months after treatment ,at the same peri-od ,carotid intimae-media thickness (IMT) was measured with color Doppler ultrasound .Results Compared with the control group ,the level of hs-CRP and lipids decreased significantly at 6 months ,12 months and 24 months after the treatment of rosu-vastatin (P<0.05). Compared with that before treatment ,IMT of the both group decreased at 6 months ,12 months and 24 months after the treatment (P<0.05) ,and it decreased significantly at 12 months and 24 months after the treatment of rosuv-astatin (P<0.01). Conclusion Rosuvastatin can obviously decrease the level of hs-CRP and lipids in patients with elderly type 2 diabetic and ischemic stroke ,and reversing the carotid atherosclerotic plaque ,and the curative effect is obviously superior tolovastatin capsules.