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目的探讨四种干预方案对新诊断2型糖尿病(T2DM)亚临床动脉粥样硬化(AS)的影响。方法采用前瞻性、病例对照研究设计,将170例(156例完成随访)无AS的新诊断T2DM患者随机分为四组:A组(强化降糖+降压治疗)、B组(强化降糖+降压+调脂治疗)、C组(在B组基础上加服维生素E0·2g/d)及D组(在B组基础上加服复方丹参滴丸30丸/d)。多因素干预2年,随访观察四组亚临床AS的发生情况及其代谢的控制情况。结果B组、C组、D组亚临床AS发生率均显著低于A组;TC和LDL-C水平较基线下降,均显著低于A组,达标率亦显著高于A组;但B、C、D组间差异无统计学意义;分析显示亚临床AS的发生与干预方案有关。结论在强化降糖、降压基础上加用调脂治疗更有利于减少新诊断T2DM患者亚临床AS的发生,口服维生素E或复方丹参滴丸对其亚临床AS的发生无保护作用。
Objective To investigate the effects of four interventions on subclinical atherosclerosis (AS) in newly diagnosed type 2 diabetes mellitus (T2DM). Methods A prospective, case-control study was designed. One hundred and seventy-six patients with newly diagnosed T2DM without AS were randomly divided into four groups: group A (intensive hypoglycemic plus antihypertensive treatment), group B (intensive hypoglycemic + Antihypertensive + lipid-lowering treatment), group C (supplemented with vitamin E0.2 g / d on the basis of group B) and group D (group B supplemented with 30 mg / d of compound danshen dropping pills). Multi-factor intervention for 2 years, followed up to observe the occurrence of subclinical AS in four groups and their metabolic control. Results The incidences of subclinical AS in group B, C and D were significantly lower than those in group A. The levels of TC and LDL-C were significantly lower than those in group A, and the compliance rates were significantly higher than those in group A. However, There was no significant difference between groups C and D. The analysis showed that the occurrence of subclinical AS was related to the intervention program. Conclusions The combination of lipid-lowering therapy with intensive hypoglycemic and antihypertensive treatment is more beneficial to reduce the occurrence of subclinical AS in newly diagnosed T2DM patients. Oral vitamin E or compound Danshen dripping pills have no protective effect on subclinical AS.