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目的观察伴血脂异常的初诊2型糖尿病调脂治疗对血糖的影响及糖脂变化的关系。方法选初诊2型糖尿病患者104例分别给予二甲双胍或格列美脲治疗12周后,检测BMI、FPG、HbA_1c、TC、TG、HDL、LDL、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)。选择其中血脂仍异常的患者98例,在原降糖药物剂量不变的基础上,根据血脂水平分别给予阿托伐他汀、非诺贝特或阿托伐他汀,与非诺贝特隔日交替治疗8周,治疗后复测上述指标。结果调脂治疗后三组血脂成分明显改善,FPG、HbA_1c均明显下降(P<0.01)。经Bivariate-correlate分析,HbA_1c的下降与TC、TG、LDL的下降呈正相关;HbA_1c的下降与ApoA呈负相关。结论调脂治疗伴有血脂异常的初诊的2型糖尿病患者在改善血脂的同时,还有利于血糖的进一步控制。
Objective To observe the effects of lipid-lowering therapy on blood glucose and the changes of glycolipid in newly diagnosed type 2 diabetic patients with dyslipidemia. Methods Totally 104 newly diagnosed type 2 diabetic patients were treated with metformin or glimepiride for 12 weeks. The levels of BMI, FPG, HbA 1c, TC, TG, HDL, LDL, ApoA and apolipoprotein B ApoB). Select the patients whose serum lipids are still abnormal, 98 patients were treated with atorvastatin, fenofibrate or atorvastatin on the basis of the unchanged dosage of the original hypoglycemic agents, alternating with fenofibrate every other day for 8 Week, after retesting the above indicators. Results After lipid-lowering treatment, the blood lipid components of the three groups were significantly improved, while FPG and HbA 1c were significantly decreased (P <0.01). The Bivariate-correlate analysis showed that the decline of HbA_1c was positively correlated with the decrease of TC, TG and LDL. The decrease of HbA_1c was negatively correlated with ApoA. Conclusion Lipid-lowering treatment of newly diagnosed type 2 diabetic patients with dyslipidemia is beneficial to the further control of blood glucose while improving blood lipid.