【摘要】 目的探讨合并2型糖尿病的高血压患者颈动脉粥样硬化程度、与高敏C-反应蛋白(hs-CRP)的关系及阿托伐他汀的干预作用。方法62例合并2型糖尿病的高血压患者(A组)和42例单纯性高血压患者(B组)入院后常规降压、降糖、抗血小板治疗,A组加用阿托伐他汀10mg,每晚1次。分别于入院后及6个月时测定血浆hs-CRP、脂蛋白(a)[LP(a)]、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbAlc),高频超声检测颈动脉,记录颈动脉内膜中层厚度(IMT)、颈动脉斑块积分、斑块发生率。结果入院时A组hs-CRP明显高于B组,分别为(8.78±1.59)mg/L和(6.34±1.43)mg/L,P<0.01,IMT、颈动脉斑块积分、斑块发生率A组也明显高于B组;阿托伐他汀治疗后hs-CRP、IMT、颈动脉斑块积分、斑块发生率分别由(8.78±1.59)mg/L、(1.24±0.13)mm、82.3%、(6.23±0.57)mm下降为(6.19±1.30)mg/L、(0.98±0.19)mm、69.5%、(5.07±0.42)mm,P<0.01。相关分析表明:hs-CRP、LP(a)与IMT、颈动脉斑块积分、斑块发生率成正相关;hsCRP与HbA1c、TG、LDL-c呈正相关(P<0.005￣0.01);结论合并2型糖尿病的高血压患者颈动脉粥样硬化程度较重;阿托伐他汀治疗可改善颈动脉粥样硬化程度及炎症反应程度,具有稳定斑块作用;③hs-CRP有致动脉硬化作用。更多还原

【Abstract】 [Objectives] To explore the relationship between arteriosclerosis of carotid artery and high sensitive C-reactive protein (hs-CRP) in patients with hypertention combining type 2 diabetes mellitus and effects of Atorvastatin. [Methods] 62 hypertention patients combing type 2 diabetes mellitus (A group) and 42 essential hypertention patients (B group) were given the regular treatment of controlling blood sugar, pressure and reducing the formation of foam cell, A group were given Atorvastatin of 10mg every night. Above all, not only hs-CRP, Lipoproteins (a) [LP (a)], total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), glucosyleted hemoglubulin-A1c (HbA1c) were detected but also carotid intima-medial thickness (IMT), calculus of carotid plaque and the prevalence rate of carotid plaque were measured by ultrasound before the treatment and 6 months after it. [Results] Before the treatment hs-CRP in group A were obviously higher than that of group B as (8.78±1.59) mg/L and (6.34±1.43) mg/L, respectively (P <0.01). IMT, calculus of carotid plaque and the prevalence rate of carotid plaque in group A were also much higher than that of group B before the treatment. Still, hs-CRP, IMT, calculus of carotid plaque and the prevalence rate of carotid plaque were all reduced after the Atorvastatin treatment from (8.78±1.59) mg/L, (1.24±0.13) mm, 82.3%, (6.23±0.57) mm to (6.19±1.30) mg/L, (0.98±0.19) mm, 69.5%, (5.07±0.42) mm and respectively (P <0.01). Some related analysis indicated that direct the hs-CRP, LP (a) was in direct proportion to IMT, calculus of carotid plaque and the prevalence rate of carotid plaque. [Conclusions] The patients with hypertention combining type 2 diabetes mellitus were more serious in level the of carotid arteriosclerosis and inflammatory reaction. Atorvastatin could lower the level of carotid arteriosclerosis and inflammatory reaction and promote stabilization of atherosclerotic plaque. The hs-CRP may lead to atherosclerosis of arteries.更多还原