中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
3期
267-270
,共4页
于冬妮%孙明晓%蒋蕾%汪耀%迟家敏%郭立新%李慧%潘琦%王晓霞
于鼕妮%孫明曉%蔣蕾%汪耀%遲傢敏%郭立新%李慧%潘琦%王曉霞
우동니%손명효%장뢰%왕요%지가민%곽립신%리혜%반기%왕효하
糖尿病,2型%血脂异常%调血脂药
糖尿病,2型%血脂異常%調血脂藥
당뇨병,2형%혈지이상%조혈지약
Diabetes mellitus,type 2%Dyslipidemias%Lipid regulating agents
目的 了解新发老年2型糖尿病患者血脂异常的发生率和知晓情况,比较辛伐他汀和血脂康的降脂效果,并分析其安全性. 方法 回顾性分析中国糖尿病并发症防治研究(CDCPS)中255例年龄在60~75岁,诊断1年之内2型糖尿病患者的血脂异常分布情况.在生活方式干预和血糖、血压控制的前提下,比较仅用生活方式干预不用药、辛伐他汀(20 mg/d)与血脂康(0.6~1.2 g/d)后血脂异常患者随访20个月的血脂水平及对肝、肾功能的变化. 结果 255例新发老年2型糖尿病患者中血脂异常的发生率为62.0%,知晓率为55.7%.血脂异常中高三酰甘油血症的发生率最高,为29.7%.在88例已知血脂异常的患者中仅有25例(28.4%)在研究进行前使用过降脂药物,其中有8例(32%)血脂降到正常水平,只有3例(12%)达到强化控制标准.与基线水平相比,随访末三酰甘油、总胆固醇和低密度脂蛋白胆固醇(LDL-C)水平较基线水平在辛伐他汀组分别降低了1.8%、10.5%和20.0%,血脂康组分别降低5.5%、15.0%和15.7%,未用药组分别降低2.7%、8.7%和4.5%.血脂异常的患者中,与仅用生活方式干预组比较,辛伐他汀和血脂康对LDL-C有降低作用(P=0.0047、0.0433).辛伐他汀与血脂康间的降脂作用并没有统计学差别.药物干预前后肝、肾脏功能无明显差异(P>0.05). 结论 针对新发老年2型糖尿病患者应检查血脂并早期实施药物干预.应用降脂药物比单纯生活方式干预能更有效降低血脂,但是血脂康和辛伐他汀的降脂作用并没有统计学差别.同时两种药物均具有良好的安全性.
目的 瞭解新髮老年2型糖尿病患者血脂異常的髮生率和知曉情況,比較辛伐他汀和血脂康的降脂效果,併分析其安全性. 方法 迴顧性分析中國糖尿病併髮癥防治研究(CDCPS)中255例年齡在60~75歲,診斷1年之內2型糖尿病患者的血脂異常分佈情況.在生活方式榦預和血糖、血壓控製的前提下,比較僅用生活方式榦預不用藥、辛伐他汀(20 mg/d)與血脂康(0.6~1.2 g/d)後血脂異常患者隨訪20箇月的血脂水平及對肝、腎功能的變化. 結果 255例新髮老年2型糖尿病患者中血脂異常的髮生率為62.0%,知曉率為55.7%.血脂異常中高三酰甘油血癥的髮生率最高,為29.7%.在88例已知血脂異常的患者中僅有25例(28.4%)在研究進行前使用過降脂藥物,其中有8例(32%)血脂降到正常水平,隻有3例(12%)達到彊化控製標準.與基線水平相比,隨訪末三酰甘油、總膽固醇和低密度脂蛋白膽固醇(LDL-C)水平較基線水平在辛伐他汀組分彆降低瞭1.8%、10.5%和20.0%,血脂康組分彆降低5.5%、15.0%和15.7%,未用藥組分彆降低2.7%、8.7%和4.5%.血脂異常的患者中,與僅用生活方式榦預組比較,辛伐他汀和血脂康對LDL-C有降低作用(P=0.0047、0.0433).辛伐他汀與血脂康間的降脂作用併沒有統計學差彆.藥物榦預前後肝、腎髒功能無明顯差異(P>0.05). 結論 針對新髮老年2型糖尿病患者應檢查血脂併早期實施藥物榦預.應用降脂藥物比單純生活方式榦預能更有效降低血脂,但是血脂康和辛伐他汀的降脂作用併沒有統計學差彆.同時兩種藥物均具有良好的安全性.
목적 료해신발노년2형당뇨병환자혈지이상적발생솔화지효정황,비교신벌타정화혈지강적강지효과,병분석기안전성. 방법 회고성분석중국당뇨병병발증방치연구(CDCPS)중255례년령재60~75세,진단1년지내2형당뇨병환자적혈지이상분포정황.재생활방식간예화혈당、혈압공제적전제하,비교부용생활방식간예불용약、신벌타정(20 mg/d)여혈지강(0.6~1.2 g/d)후혈지이상환자수방20개월적혈지수평급대간、신공능적변화. 결과 255례신발노년2형당뇨병환자중혈지이상적발생솔위62.0%,지효솔위55.7%.혈지이상중고삼선감유혈증적발생솔최고,위29.7%.재88례이지혈지이상적환자중부유25례(28.4%)재연구진행전사용과강지약물,기중유8례(32%)혈지강도정상수평,지유3례(12%)체도강화공제표준.여기선수평상비,수방말삼선감유、총담고순화저밀도지단백담고순(LDL-C)수평교기선수평재신벌타정조분별강저료1.8%、10.5%화20.0%,혈지강조분별강저5.5%、15.0%화15.7%,미용약조분별강저2.7%、8.7%화4.5%.혈지이상적환자중,여부용생활방식간예조비교,신벌타정화혈지강대LDL-C유강저작용(P=0.0047、0.0433).신벌타정여혈지강간적강지작용병몰유통계학차별.약물간예전후간、신장공능무명현차이(P>0.05). 결론 침대신발노년2형당뇨병환자응검사혈지병조기실시약물간예.응용강지약물비단순생활방식간예능경유효강저혈지,단시혈지강화신벌타정적강지작용병몰유통계학차별.동시량충약물균구유량호적안전성.
Objective To observe the incidence and awareness of dyslipidemia in newly diagnosed elderly type 2 diabetic patients,and to determine the efficacy and safety of simvastatin and Xuezhikang in the treatment of dyslipidemia.Methods Totally 255 newly diagnosed type 2 diabetic patients aged 60 to 75 years in CDCPS research were included and the incidence of dyslipidemia were retrospectively analyzed.Patients were divided into 3 groups:the group 1 was given simvastatin (20 mg/d); the group 2 was given Xuezhikang (0.6~ 1.2 g/d); the group 3 was given no lipid-lowering drugs.All the three groups were given lifestyle intervention and blood pressure and blood sugar control.All patients were followed up monthly and TG,TC,LDL-C,BUN,ALT and creatinine were examined at 7th,14th,and 20th months.Results The incidence of dyslipidemia and the rate of awareness in the study cohort was 62% and 55.7%.Hypertriglyceridemia was the most common type of dyslipidemia (29%).Among 88 patients with dyslipidemia,25 (28.4%) patients had been treated with lipid-lowering drugs before our study,in whom,8(32%) patients had normal serum lipid levels and only 3 (12%)patients reached to the control standards.20 months after the treatment,the decrement scales of TG,TC and LDL-C were 1.8%,10.5 % and 20 % respectively in group 1;5.5 %,15.0% and 15.7% respectively in group 2;2.7%,8.7% and 4.5% respectively in group 3.The long-term lifestyle intervention and blood pressure and blood sugar control reduced serum lipid to some degree.In the patients with dyslipidemia,lipid-lowering drugs had a better effect on serum lipid reduction than did the lifestyle intervention (P=0.0047,0.0433).There was no significant difference between simvastatin and Xuezhikang.The function changes of liver and kidney had no difference before and after drug intervention (P>0.05).Conclusions Serum lipid should be monitored and early medicine intervention should be taken in newly diagnosed elderly type 2 diabetic patients.Medicine intervention has a better effect on serum lipid reduction than lifestyle intervention,and there are no significant differences in efficacy and safety between simvastatin and Xuezhikang.