阿托伐他汀对2型糖尿病患者血脂及氧化应激的影响

【目的】观察2型糖尿病（T2DM）患者氧化应激水平的变化及阿托伐他汀对患者血脂及氧化应激状态的影响。【方法】采用前瞻性随机病例对照研究，选择60例T2DM患者分为糖尿病常规治疗组（A组，n=30）及阿托伐他汀治疗组（B组，n=30）和15例正常人作为对照（C组，n=15）。A组的T2DM患者予以口服降糖药或胰岛素控制血糖、钙离子拮抗剂控制血压等治疗；B组在常规治疗组的基础上予以阿托伐他汀（阿乐，10～20mg，口服，每晚一次）治疗，治疗时间为8周。留取血清自动生化仪测定血清总胆固醇（TC）、甘油三酯（TG）、空腹血糖（FBG）、糖化血红蛋白（HbAIc），比色法测定谷胱苷肽过氧化物酶（GSH—Px）、超氧化物歧化酶（SOD）、丙二醛（MDA）水平。【结果】与C组相比，2型糖尿病患者的血清GSH—Px、SOD水平降低，MDA水平升高，差异具有显著性（P〈0．01）。B组治疗后血清GSH—Px、SOD水平增加，MDA水平降低，较治疗前有显著性差异（P〈0．05），与同期A组比较，差异有显著性（P〈0．01）。【结论】T2DM患者氧化应激水平较正常人显著升高，阿托伐他汀可降低患者的氧化应激水平。

Effect of Atorvastatin on Blood Lipids and Oxidative Stress in Patients with Type 2 Diabetes

Objeetive]To study the effect of atorvastatin on blood lipids and oxidative stress in patients with type 2 diabetes. Methods]Sixty type 2 diabetes patients were randomly divided into three groups. Group DM（ n = 30） received normal treatment. Atorvastatin therapy group （Group A, n = 30） received normal treatment plus atorvastatin10-20 mg/d for 8 weeks. Group C included 15 healthy individuals. The serum levels of glucose, glycosylated hemoglobin（HbAlc） and blood lipids were measured by automatic biochemistry analysis apparatus. Glutathione Peroxidase（GSH-Px）, superoxide dismutase（SOD） and malondialdehyde（MDA） were measured. Results]The serum levels of GSH-Px and SOD decreased significantly in group DM and group A compared to group C （ P 〈0.01）, while increased significantly after atorvastatin treatment（ P 〈0. 05）. The serum level of MDA increased significantly in group DM and group A compared to group C（ P 〈0.01）, while decreased significantly after atorvastatin treatment（ P 〈0.05）. Correlation analysis showed that serum levels of MDA was positively related to TC and the coefficient correlation was 0.62（ P 〈0.01）. Serum levels of GSH-Px and SOD were negatively related to HbAlc and the coefficient correlations were -0. 47 and -0. 58（ P 〈0.05）, respectively. Conclusion] Serum level of oxidative stress in type 2 diabetic patients is significantly higher that of normal person. Atorvastatin therapy can significantly reduce oxidative stress levels in type 2 diabetic patients.