目的 探讨瑞舒伐他汀对代谢综合征(MS)患者的干预作用及其安全性.方法 将80例MS患者随机分为两组,瑞舒伐他汀组(40例)给予瑞舒伐他汀10 mg/d口服;阿托伐他汀组(40例)给予阿托伐他汀10 mg/d口服.随访12周,主要观察指标:载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)比值及炎症因子超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素18(IL-18),次要观察指标:血脂、血糖、空腹胰岛素(FIN)、胰岛素抵抗指数(HOMA-IR)、血压、尿白蛋白排泄率(UAER)、体质量指数(BMI),安全性指标:肝肾功能、肌酸激酶(CK).比较两组患者治疗前、后及两组治疗后各指标的差异.结果 (1)与治疗前比较,治疗12周后两组患者ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18及ApoB、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、FIN、HOMA-IR、收缩压(SBP)、舒张压(DBP)、UAER均显著下降[瑞舒伐他汀组分别为:1.26 ±0.25降至0.63 ±0.22,t=4.44;(6.89±1.43) mg/L降至(2.41 ±0.36) mg/L,t=7.12;(27.63±7.12) ng/L降至(12.98 ±3.74)ng/L,t=4.23;(26.47 ±6.59) ng/L降至(13.16 ±3.55) ng/L,t=4.45;(318.36 ±90.45) ng/L降至(172.77±50.65) ng/L,t=3.92;(1.58 ±0.29) g/L降至(0.83 ±0.23) g/L,t=4.20;(5.78 ±0.86)mmol/L降至(3.53±0.69) mmoL/L,t=3.85;(3.52±0.54)mmol/L降至(2.04 ±0.49) mmol/L,t=3.89;(2.87±0.65) mmol/L降至(1.91 ±0.57) mmol/L,t=3.78;(12.08 ±2.87) mU/L降至(6.87±1.89) mU/L,t=3.98;3.42 ±0.57降至1.60 ±0.31,t=4.65;(144.6±13.3) mm Hg降至(135.1±12.7) mm Hg,t=3.57;(93.6±9.5) mmHg降至(85.2±7.6) mm Hg,t=3.59;(29.86±3.37) μμg/min降至(22.52±2.56) μg/min,t=3.71;阿托伐他汀组:1.24±0.23降至0.92 ±0.24,t=3.74;(6.84±1.37) mg/L降至(3.50 ±0.75) mg/L,t=4.24; (27.22 ±7.36) ng/L降至(18.70±5.82) ng/L,t=3.76;(26.28±6.84) ng/L降至(19.34±5.96) ng/L,t=3.75;(311.22±91.98)ng/L降至(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L降至(1.14±0.26) g/L,t=3.74;(5.65±0.76) mmol/L降至(4.67±0.65) mmol/L,t=3.68;(3.51 ±0.55) mmol/L降至(2.65±0.57) mmol/L,t=3.70; (2.86±0.68) mmol/L降至(2.05±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L降至(8.91 ±2.32) mU/L,t=3.74;3.38 ±0.54降至2.18±0.35,t=3.80;(144.0±13.8) mmHg降至(135.7±12.5) mm Hg,t=3.56;(93.4±9.3) mm Hg降至(85.8±8.9) mm Hg,t=3.58;(29.77±3.28)μg/min降至(23.02±2.83) μg/min,t=3.67;P均＜0.01];ApoA1、高密度脂蛋白胆固醇(HDL-C)有所升高,但差异均无统计学意义(P均＞0.05);空腹血糖(FPG)、餐后2h血糖(2 hPG) 、BMI有下降趋势,但差异均无统计学意义(P均＞0.05).(2)治疗12周后,瑞舒伐他汀组的ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18及ApoB 、TC、LDL-C、FIN、HOMA-IR与阿托伐他汀组相比明显降低(t值分别为2.11、2.10、2.09、2.12、2.08、2.07、2.05、2.04、2.04、2.06,P均＜0.05);瑞舒伐他汀组的HDL-C、ApoA1与阿托伐他汀组相比有增高趋势,但差异均无统计学意义(P均＞0.05);两组对TG的改善差异均无统计学意义(P均＞0.05);两组对SBP、DBP、UAER的改善亦无统计学意义(P均＞0.05).(3)瑞舒伐他汀组不良反应少,安全性好.结论 瑞舒伐他汀可降低MS患者ApoB/ApoA1比值和炎症因子水平,改善胰岛素抵抗,其安全性良好.
目的 探討瑞舒伐他汀對代謝綜閤徵(MS)患者的榦預作用及其安全性.方法 將80例MS患者隨機分為兩組,瑞舒伐他汀組(40例)給予瑞舒伐他汀10 mg/d口服;阿託伐他汀組(40例)給予阿託伐他汀10 mg/d口服.隨訪12週,主要觀察指標:載脂蛋白B/載脂蛋白A1(ApoB/ApoA1)比值及炎癥因子超敏C反應蛋白(hs-CRP)、腫瘤壞死因子α(TNF-α)、白細胞介素6(IL-6)、白細胞介素18(IL-18),次要觀察指標:血脂、血糖、空腹胰島素(FIN)、胰島素牴抗指數(HOMA-IR)、血壓、尿白蛋白排洩率(UAER)、體質量指數(BMI),安全性指標:肝腎功能、肌痠激酶(CK).比較兩組患者治療前、後及兩組治療後各指標的差異.結果 (1)與治療前比較,治療12週後兩組患者ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18及ApoB、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、甘油三酯(TG)、FIN、HOMA-IR、收縮壓(SBP)、舒張壓(DBP)、UAER均顯著下降[瑞舒伐他汀組分彆為:1.26 ±0.25降至0.63 ±0.22,t=4.44;(6.89±1.43) mg/L降至(2.41 ±0.36) mg/L,t=7.12;(27.63±7.12) ng/L降至(12.98 ±3.74)ng/L,t=4.23;(26.47 ±6.59) ng/L降至(13.16 ±3.55) ng/L,t=4.45;(318.36 ±90.45) ng/L降至(172.77±50.65) ng/L,t=3.92;(1.58 ±0.29) g/L降至(0.83 ±0.23) g/L,t=4.20;(5.78 ±0.86)mmol/L降至(3.53±0.69) mmoL/L,t=3.85;(3.52±0.54)mmol/L降至(2.04 ±0.49) mmol/L,t=3.89;(2.87±0.65) mmol/L降至(1.91 ±0.57) mmol/L,t=3.78;(12.08 ±2.87) mU/L降至(6.87±1.89) mU/L,t=3.98;3.42 ±0.57降至1.60 ±0.31,t=4.65;(144.6±13.3) mm Hg降至(135.1±12.7) mm Hg,t=3.57;(93.6±9.5) mmHg降至(85.2±7.6) mm Hg,t=3.59;(29.86±3.37) μμg/min降至(22.52±2.56) μg/min,t=3.71;阿託伐他汀組:1.24±0.23降至0.92 ±0.24,t=3.74;(6.84±1.37) mg/L降至(3.50 ±0.75) mg/L,t=4.24; (27.22 ±7.36) ng/L降至(18.70±5.82) ng/L,t=3.76;(26.28±6.84) ng/L降至(19.34±5.96) ng/L,t=3.75;(311.22±91.98)ng/L降至(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L降至(1.14±0.26) g/L,t=3.74;(5.65±0.76) mmol/L降至(4.67±0.65) mmol/L,t=3.68;(3.51 ±0.55) mmol/L降至(2.65±0.57) mmol/L,t=3.70; (2.86±0.68) mmol/L降至(2.05±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L降至(8.91 ±2.32) mU/L,t=3.74;3.38 ±0.54降至2.18±0.35,t=3.80;(144.0±13.8) mmHg降至(135.7±12.5) mm Hg,t=3.56;(93.4±9.3) mm Hg降至(85.8±8.9) mm Hg,t=3.58;(29.77±3.28)μg/min降至(23.02±2.83) μg/min,t=3.67;P均＜0.01];ApoA1、高密度脂蛋白膽固醇(HDL-C)有所升高,但差異均無統計學意義(P均＞0.05);空腹血糖(FPG)、餐後2h血糖(2 hPG) 、BMI有下降趨勢,但差異均無統計學意義(P均＞0.05).(2)治療12週後,瑞舒伐他汀組的ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18及ApoB 、TC、LDL-C、FIN、HOMA-IR與阿託伐他汀組相比明顯降低(t值分彆為2.11、2.10、2.09、2.12、2.08、2.07、2.05、2.04、2.04、2.06,P均＜0.05);瑞舒伐他汀組的HDL-C、ApoA1與阿託伐他汀組相比有增高趨勢,但差異均無統計學意義(P均＞0.05);兩組對TG的改善差異均無統計學意義(P均＞0.05);兩組對SBP、DBP、UAER的改善亦無統計學意義(P均＞0.05).(3)瑞舒伐他汀組不良反應少,安全性好.結論 瑞舒伐他汀可降低MS患者ApoB/ApoA1比值和炎癥因子水平,改善胰島素牴抗,其安全性良好.
목적 탐토서서벌타정대대사종합정(MS)환자적간예작용급기안전성.방법 장80례MS환자수궤분위량조,서서벌타정조(40례)급여서서벌타정10 mg/d구복;아탁벌타정조(40례)급여아탁벌타정10 mg/d구복.수방12주,주요관찰지표:재지단백B/재지단백A1(ApoB/ApoA1)비치급염증인자초민C반응단백(hs-CRP)、종류배사인자α(TNF-α)、백세포개소6(IL-6)、백세포개소18(IL-18),차요관찰지표:혈지、혈당、공복이도소(FIN)、이도소저항지수(HOMA-IR)、혈압、뇨백단백배설솔(UAER)、체질량지수(BMI),안전성지표:간신공능、기산격매(CK).비교량조환자치료전、후급량조치료후각지표적차이.결과 (1)여치료전비교,치료12주후량조환자ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18급ApoB、총담고순(TC)、저밀도지단백담고순(LDL-C)、감유삼지(TG)、FIN、HOMA-IR、수축압(SBP)、서장압(DBP)、UAER균현저하강[서서벌타정조분별위:1.26 ±0.25강지0.63 ±0.22,t=4.44;(6.89±1.43) mg/L강지(2.41 ±0.36) mg/L,t=7.12;(27.63±7.12) ng/L강지(12.98 ±3.74)ng/L,t=4.23;(26.47 ±6.59) ng/L강지(13.16 ±3.55) ng/L,t=4.45;(318.36 ±90.45) ng/L강지(172.77±50.65) ng/L,t=3.92;(1.58 ±0.29) g/L강지(0.83 ±0.23) g/L,t=4.20;(5.78 ±0.86)mmol/L강지(3.53±0.69) mmoL/L,t=3.85;(3.52±0.54)mmol/L강지(2.04 ±0.49) mmol/L,t=3.89;(2.87±0.65) mmol/L강지(1.91 ±0.57) mmol/L,t=3.78;(12.08 ±2.87) mU/L강지(6.87±1.89) mU/L,t=3.98;3.42 ±0.57강지1.60 ±0.31,t=4.65;(144.6±13.3) mm Hg강지(135.1±12.7) mm Hg,t=3.57;(93.6±9.5) mmHg강지(85.2±7.6) mm Hg,t=3.59;(29.86±3.37) μμg/min강지(22.52±2.56) μg/min,t=3.71;아탁벌타정조:1.24±0.23강지0.92 ±0.24,t=3.74;(6.84±1.37) mg/L강지(3.50 ±0.75) mg/L,t=4.24; (27.22 ±7.36) ng/L강지(18.70±5.82) ng/L,t=3.76;(26.28±6.84) ng/L강지(19.34±5.96) ng/L,t=3.75;(311.22±91.98)ng/L강지(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L강지(1.14±0.26) g/L,t=3.74;(5.65±0.76) mmol/L강지(4.67±0.65) mmol/L,t=3.68;(3.51 ±0.55) mmol/L강지(2.65±0.57) mmol/L,t=3.70; (2.86±0.68) mmol/L강지(2.05±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L강지(8.91 ±2.32) mU/L,t=3.74;3.38 ±0.54강지2.18±0.35,t=3.80;(144.0±13.8) mmHg강지(135.7±12.5) mm Hg,t=3.56;(93.4±9.3) mm Hg강지(85.8±8.9) mm Hg,t=3.58;(29.77±3.28)μg/min강지(23.02±2.83) μg/min,t=3.67;P균＜0.01];ApoA1、고밀도지단백담고순(HDL-C)유소승고,단차이균무통계학의의(P균＞0.05);공복혈당(FPG)、찬후2h혈당(2 hPG) 、BMI유하강추세,단차이균무통계학의의(P균＞0.05).(2)치료12주후,서서벌타정조적ApoB/ApoA1、hs-CRP、TNF-α、IL-6、IL-18급ApoB 、TC、LDL-C、FIN、HOMA-IR여아탁벌타정조상비명현강저(t치분별위2.11、2.10、2.09、2.12、2.08、2.07、2.05、2.04、2.04、2.06,P균＜0.05);서서벌타정조적HDL-C、ApoA1여아탁벌타정조상비유증고추세,단차이균무통계학의의(P균＞0.05);량조대TG적개선차이균무통계학의의(P균＞0.05);량조대SBP、DBP、UAER적개선역무통계학의의(P균＞0.05).(3)서서벌타정조불량반응소,안전성호.결론 서서벌타정가강저MS환자ApoB/ApoA1비치화염증인자수평,개선이도소저항,기안전성량호.
Objective To investigate the efficacy of rosuvastatin on treating patients with metabolic syndrome(MS).Methods Eighty MS patients were divided into rosuvastatin group (n =40) and atorvastatin group(n =40).Patients in rosuvastatin group were received schufftan at dose of 10 mg/d and in atorvastatin group were received lipitor at dose of 10 mg/d orally.Patients were followed-up for 12 weeks.The ratio of apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) and inflammatory factors including high-sensitivity Czreactive protein (hs-CRP),tumor necrosis factor-oα (TNF-α),interleukin-6 (IL-6),and interleukin-18 (IL-18) were measured.Meanwhile Secondary factors:blood lipids,blood glucose,fasting insulin (FIN),insulin resistance index (HOMA-IR),blood pressure,urine albumin excretion rate (UAER),body mass index (BMI).As well as safety indicators:hepatic and renal function and creatine kinase (CK) were detected.Results (1) After 12-week's treatment,the serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triglyceride (TG),FIN,HOMA-IR,systolic blood pressure (SBP),diastolic blood pressure (DBP),and UAER significantly decreased compared to before treatment in the two groups(rosuvastatin group:1.26 ± 0.25 vs.0.63 ± 0.22,t =4.44 ; (6.89 ± 1.43) mg/L vs.(2.41 ± 0.36) mg/L,t =7.12;(27.63 ±7.12) ng/L vs.(12.98 ±3.74) ng/L,t =4.23;(26.47 ±6.59) ng/L vs.(13.16± 3.55) ng/L,t =4.45;(318.36 ±90.45) ng/L vs.(172.77 ±50.65) ng/L,t =3.92;(1.58 ±0.29) g/L vs.(0.83 ± 0.23) g/L,t =4.20; (5.78 ± 0.86) mmol/L vs.(3.53 ± 0.69) mmol/L,t =3.85 ; (3.52 ± 0.54) mmol/L vs.(2.04±0.49) mmol/L,t =3.89;(2.87 ±0.65) mmol/L vs.(1.91 ±0.57) mmol/L,t =3.78; (12.08 ± 2.87) mU/L vs.(6.87 ± 1.89) mU/L,t =3.98 ; 3.42 ± 0.57 vs.1.60 ± 0.31,t =4.65 ; (144.6 ± 13.3) mm Hg vs.(135.1 ±12.7) mm Hg,t =3.57;(93.6 ±9.5) mm Hg vs.(85.2 ±7.6) mm Hg,t =3.59; (29.86 ± 3.37) μg/min vs.(22.52 ± 2.56) μg/min,t =3.71 ; atorvastatin group:1.24 ± 0.23 vs.0.92 ± 0.24,t =3.74 ; (6.84 ± 1.37) mg/L vs.(3.50 ± 0.75) mg/L,t =4.24 ; (27.22 ± 7.36) ng/L vs.(18.70 ± 5.82) ng/L,t =3.76; (26.28 ±6.84) ng/L vs.(19.34 ± 5.96) ng/L,t =3.75 ; (311.22 ±91.98) ng/L vs.(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L vs.(1.14±0.26) g/L,t =3.74;(5.65 ±0.76) mmol/L vs.(4.67±0.65) mmol/L,t =3.68;(3.51 ±0.55) mmol/L vs.(2.65 ±0.57) mmol/L,t =3.70; (2.86±0.68) mmol/Lvs.(2.05 ±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L vs.(8.91 ±2.32) mU/L,t =3.74;3.38 ±0.54 vs.2.18 ±0.35,t =3.80;(144.0 ± 13.8) mm Hg vs.(135.7 ±12.5) mm Hg,t =3.56 ; (93.4 ± 9.3) mm Hg vs.(85.8 ± 8.9) mm Hg,t =3.58 ; (29.77 ± 3.28) μg/min vs.(23.02 ± 2.83) μg/min,t =3.67 ;P ＜ 0.01).ApoA1 and high-density lipoprotein cholesterol (HDL-C) had increase,but there was no significant difference(P ＞ 0.05).Fasting plasma glucose(FPG),2 h postprandial blood glucose (2 hPG) and BMI tended to decrease,but there were no significant differences(P ＞ 0.05).(2)The serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,TC,LDL-C,FIN and HOMA-IR in the rosuvastatin group were significantly lower than those in the atorvastatin group at the 12th-week follow-up(t =2.11,2.10,2.09,2.12,2.08,2.07,2.05,2.04,2.04,2.06 respectively; P ＜ 0.05).The serum levels of HDL-C and ApoA1 in the rosuvastatin group tended to increase compared with the atorvastatin group after 12-week treatment (P ＞ 0.05).There were no statistically significant differences in term of TG,SBP,DBP,UAER between the two groups (P ＞ 0.05).(3) The adverse effect in the rosuvastatin group was fewer than that in atorvastatin group.Conclusion Rosuvastatin can reduce ApoB/ApoA1 ratio and the levels of inflammatory cytokines,improve insulin resistance in patients with MS and less adverse effect were seen.
