摘要
目的探讨他汀类药物一级预防对老年2型糖尿病合并脑梗死患者预后的影响。方法选取汕头市中心医院2016年6月至2017年6月收治的老年2型糖尿病合并脑梗死患者62例为研究对象。将起病半年前服用阿托伐他汀(10 mg/d)的30例患者作为观察组,同期入院前未应用他汀类的32例脑梗死患者作为对照组,比较两组患者入院时的危险因素、空腹血糖、糖化血红蛋白、血脂水平、神经功能缺损情况,给予相同治疗方案治疗2周后评估神经功能缺损情况。结果观察组患者的饮酒、吸烟、冠心病、高脂血症、既往脑卒中、高血压比率分别为20.00%,63.34%,50.00%、73.33%,40.00%,70.00%,与对照组的28.00%、65.63%,56.25%,71.88%,34.38%,75.00%比较,均差异无统计学意义(x^2=0.121,0.213,0.197,0.195、0.142、0.139,P=0.327、0.644、0.542、0.530,0.475、0.453).观察组患者甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇分别为(3.68±0.81)mmol/L,(1-35±0.46)mmol/L、(2.65±1.36)mmol/L,(1.38±0.56)mmol/L,与对照组的(5.45±1.24)mmol/L、(l.83±0.76)mmol/L,(3.89±1.51)mmol/L,(0.92±0.33)mmol/L比较,均差异有统计学意义(t=5.621、5.825、4.916、5.103,P=0.012、0.013、0.022、0.020)。观察组的血糖、糖化血红蛋白分别为(6.58±2.87)mmol/L.(7.18±1.48)%,与对照组的(6.84±3.14)mmol/L、(7.05±1.49)%比较,均差异有统计学意义(t=1.049、l.199,P=0.301、0.362)。治疗前后对照组的美国国立卫生研究院卒中量表(NIHSS)为(15.2±4.3)分和(4.9±0.8)分,高于观察组的(14.8±3.8)分和(7.1±0.7)分,均差异有统计学意义(t=4.879、5.268,P=0.028、0.016)。结论他汀类药物一级预防能改善老年2型糖尿病合并脑梗死患者的血脂水平及神经缺损功能,减少致残程度。
Objective To investigate the effect of statins on the prognosis of senile diabetic patients with cerebral infarction.Methods Sixty - two elderly patients with diabetes mellitus and cerebral infarction admitted to Shantou Central Hospital from June 2016 to June 2017 were selected.Thirty patients who took atorvastatin( 10 mg/d) six months before onset were selected as observation group.At the same time,32 cases of cerebral infarction who were not given statins were selected as control group.The risk factors on admission to hospital, fasting glucose, glycosylated hemoglobin, blood lipid levels and neural function defect were compared between the two groups.The nerve function defect was evaluated after treatment for 2 weeks.Results In the observation group, the rates of drinking, smoking, coronary heart disease,hyperlipidemia,previous stroke and hypertension were 20.00%,63.34%,50.00%,73.33%, 40.00%,70.00%, respectively,compared with the control group (28.00%,65.63%,56.25%,71.88%,34.38%, 75.00%),there were no statistically significant differences ( x^2= 0.121,0.213,0.197,0.195,0.142,0.139,P = 0.327 ,0.644,0.542,0.530,0.475 ,0.453).The triglyceride, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol in the observation group were (3.68 ± 0.81 ) mmol/L,( 1.35 ± 0.46) mmol/L,(2.65 ± 1.36) mmol/L,( 1.38 ±0.56) mmol/L, respectively, which in the control group were (5.45 ± 1.24) mmol/L,(1.83 ±0.76) mmol/L,(3.89 ± 1.51 ) mmol/L,(0.92 ± 0.33 ) mmol/L, respectively, the differences were statistically significant between the two groups (t = 5.621,5.825 ,4.916,5.103 ,P =0.012,0.013,0.022,0.020).The levels of blood glucose and glycosylated hemoglobin in the observation group were (6.58 ±2.87)mmol/L,(7.18 ± 1.48)%,respectively, which in the control group were (6.84 ±3.14) mmol/L,(7.05 ± 1.49)%, respectively, the differences were statistically significant (t= 1.049,1.199,P = 0.301,0.362).The national institutes of health stroke scale (NIHSS) scores of the control group before and after treatment were ( 15.2 ± 4.3 ) points and (4.9 ±0.8) points, respectively, which were higher than those of the observation group [(14.8 ±3.8) points and (7.1 ±0.7) points ], and the differences were statistically significant (t = 4.879,5.268, P = 0.028,0.016).Conclusion The primary prevention of statins can improve the blood lipid level and nerve function of senile diabetic patients with cerebral infarction, as well as reduce the degree of disability.
作者
沈闲茹
李健飞
Shen Xianru;Li Jianfei(Department of Endocrinology, Shantou Central Hospital, Shantou, Guangdong 515031 , China)
出处
《中国基层医药》
CAS
2019年第13期1582-1585,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省汕头市医疗卫生科技计划引导项目(汕府科[2015]J123号-8).
关键词
糖尿病
2型
脑梗死
一级预防
预后
老年人
降血脂药物
Diabetes mellitus, type 2
Brain infarction
Primary prevention
Prognosis
Aged
Antilipemnc agents
