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目的:观察陈旧性心肌梗死(OMI)伴高脂血症患者胰岛素抵抗(IR)状态及辛伐他汀对其影响。方法:48例OMI伴高脂血症患者随机分为常规治疗组(R组)24例和常规+辛伐他汀治疗组(S组)24例。比较二组治疗前后血脂水平(TC、TG、LDL-C、HDL-C)、空腹血糖(FPG)、胰岛素抵抗(HOMA-IR)和胰岛素敏感指数(ISI)的变化,并与24例健康对照组(C组)比较。结果:与对照组相比,OMI伴高脂血症患者TC、TG、LDL-C升高,HDL-C降低(P<0.05);CHD组FPG有上升趋势(P>0.05),FINS增高,ISI下降,IR增高(均P<0.01),ISI降低,HOMA-IR增加(P<0.001);R组和S组患者治疗后ISI升高,而HOMA-IR降低,S组治疗后ISI增高和HOMA-IR降低的程度明显优于R组(P<0.05)。结论:OMI伴高脂血症患者存在IR,辛伐他汀可提高其胰岛素敏感性。
Objective: To observe the state of insulin resistance (IR) in patients with old myocardial infarction (OMI) and hyperlipidemia and the effect of simvastatin on it. Methods: Forty-eight patients with OMI and hyperlipidemia were randomly divided into routine treatment group (R group) 24 cases and routine + simvastatin treatment group (S group) 24 cases. The changes of blood lipid (TC, TG, LDL-C, HDL-C), fasting blood glucose (FPG), insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were compared between the two groups before and after treatment. Group (Group C) comparison. Results: Compared with the control group, the levels of TC, TG, LDL-C and HDL-C in OMI patients with hyperlipidemia were decreased (P <0.05); FPG in CHD group was increased (P> 0.05) ISI decreased, IR increased (all P <0.01), ISI decreased and HOMA-IR increased (P <0.001); ISI increased and HOMA-IR decreased after treatment in R group and S group, ISI increased in S group HOMA-IR decreased significantly better than the R group (P <0.05). Conclusion: OMI with hyperlipidemia in patients with IR, simvastatin can increase its insulin sensitivity.