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目的探讨不同剂量瑞舒伐他汀对急性冠脉综合征(ACS)合并糖尿病患者的临床疗效及对血清中高敏C反应蛋白(hs-CRP)、血糖的影响。方法选择2012年8月至2014年8月于我院心内科住院的164例ACS合并糖尿病患者,随机分为试验组和对照组,每组82例,在控制血糖和低脂饮食的基础上,试验组自入院始服用瑞舒伐他汀20 mg/d,对照组自入院始服用瑞舒伐他汀10mg/d,观察住院期间及4周12周血脂情况及肝肾功能、肌酶的变化,同时采用酶联免疫吸附法测定两组患者服用瑞舒伐他汀前后血清hs-CRP水平及血糖、Hb A1c水平。结果患者住院期间及服瑞舒伐他汀4周12周后,LDL-C水平均有显著下降,差异有统计学意义(P<0.05)。转氨酶肌酶肝肾功能及肌溶解发生率方面差异无统计学意义(P>0.05)试验组与对照组治疗前后血清hs-CRP水平均显著降低,对照组入院时(19.68±12.62)mg/L,4周(12.69±10.59)mg/L,12周(10.07±9.63)mg/L;实验组入院时(19.70±12.50)mg/L,4周(11.23±8.64)mg/L,12周(8.32±7.59)mg/L,组间差异有统计学意义(P<0.01),血糖、Hb A1c两组均无明显变化(P>0.05)。结论瑞舒伐他汀可显著降低ACS合并糖尿病患者LDL-C、血清hs-CRP水平,对血糖无明显影响,安全性好。
Objective To investigate the clinical effects of different doses of rosuvastatin on acute coronary syndrome (ACS) with diabetes and its effect on serum hs-CRP and blood glucose. Methods A total of 164 ACS patients with diabetes mellitus who were hospitalized in Department of Cardiology, our hospital from August 2012 to August 2014 were randomly divided into experimental group and control group, with 82 cases in each group. On the basis of controlling blood sugar and low fat diet, The trial group took rosuvastatin 20 mg / d after hospital admission, and the control group took rosuvastatin 10 mg / d after hospital admission. The changes of blood lipid, liver and kidney function and muscle enzymes during hospitalization and 12 weeks after 4 weeks were observed. Serum hs-CRP levels, blood glucose, and Hb A1c levels were measured by enzyme-linked immunosorbent assay before and after rosuvastatin administration in both groups. Results The LDL-C levels of patients in the hospital and after taking rosuvastatin for 4 weeks were significantly decreased (P <0.05). The serum hs-CRP levels of the experimental group and the control group were significantly lower than those of the control group (19.68 ± 12.62 mg / L, P <0.05) (12.69 ± 10.59) mg / L for 4 weeks (10.07 ± 9.63) mg / L for 12 weeks and 19.70 ± 12.50 mg / L for admission and 11.23 ± 8.64 mg / ± 7.59) mg / L, there was a significant difference between the two groups (P <0.01). There was no significant difference between the two groups (P> 0.05). Conclusion Rosuvastatin can significantly reduce the level of LDL-C and serum hs-CRP in ACS patients with diabetes mellitus, with no significant effect on blood glucose and good safety.