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目的探讨辛伐他汀对2型糖尿病合并肾病葡萄糖代谢、胰岛素敏感性以及胰岛素抵抗的影响。方法从2013年4月到2014年1月,选取我院的96例2型糖尿病合并肾病患者进行回顾性分析,进行辛伐他汀治疗3个月,分析治疗前后空腹血糖(FBG)、C肽(CRP)、糖基化血红蛋白(Hb A1c)、胰岛素(FINS)水平、胰岛素敏感指数、胰岛素/葡萄糖比率(IGR)、HOMA-IR、脂联素(APN)以及游离脂肪酸水平等变化,以评价辛伐他汀对2型糖尿病合并肾病患者的治疗效果。结果患者进行辛伐他汀治疗3个月后进行OGTT试验,各时点血糖水平较治疗前均显著下降(P<0.05),而胰岛素与C肽在口服葡萄糖后0 min和30 min时较治疗前显著下降(P<0.05);FBG、Hb A1c、CRP的水平在治疗后均有显著下降(P<0.05),UAER明显下降(P<0.05),血糖AUC和胰岛素AUC在治疗后显著下降(P<0.05),而C肽AUC则显著上升(P<0.05);FINS及ISI在辛伐他汀治疗后明显降低(P<0.05),IGR及CIR无显著变化(P>0.05);FFA明显降低(P<0.05),APN后显著上升(P<0.05),HOMA-IR在治疗后显著降低(P<0.05)。结论辛伐他汀治疗可以显著降低血糖,提高患者对胰岛素的敏感性,改善胰岛素抵抗,从而改善2型糖尿病合并肾病患者的糖代谢,值得临床进一步推广。
Objective To investigate the effects of simvastatin on glucose metabolism, insulin sensitivity and insulin resistance in type 2 diabetic nephropathy. Methods From April 2013 to January 2014, 96 patients with type 2 diabetic nephropathy in our hospital were retrospectively analyzed. After simvastatin treatment for 3 months, the levels of fasting blood glucose (FBG) and C-peptide CRP, Hb A1c, FINS, insulin sensitivity index, insulin / glucose ratio (IGR), HOMA-IR, APN and free fatty acid Therapeutic effect of statin on type 2 diabetic patients with nephropathy. Results OGTT was performed 3 months after simvastatin treatment. The blood glucose levels at each time point were significantly lower than those before treatment (P <0.05), while those of insulin and C peptide at 0 and 30 minutes after oral administration of glucose were significantly lower than those before treatment (P <0.05). The levels of FBG, Hb A1c and CRP were significantly decreased (P <0.05), UAER was significantly decreased (P <0.05), and the AUC and AUC of blood glucose were significantly decreased after treatment (P <0.05), while the AUC of C peptide increased significantly (P <0.05). FINS and ISI decreased significantly after simvastatin treatment (P <0.05), while there was no significant change in IGR and CIR P <0.05), but increased significantly after APN (P <0.05). HOMA-IR decreased significantly after treatment (P <0.05). Conclusion Simvastatin can significantly reduce blood glucose, improve insulin sensitivity and improve insulin resistance in patients with type 2 diabetes mellitus and improve renal function in patients with glucose metabolism, which is worth further clinical promotion.