الملخص
Objective: To explore therapeutic effect of different doses of atorvastatin on patients with diabetic cardiomyopathy (DCM) and its influence on levels of blood lipids, glycosylated hemoglobin A1c (HbA1c), advanced glycosylation end product (AGEs) and cardiac diastolic function. Methods: A total of 96 DCM patients treated in our hospital were selected, randomly and equally divided into routine dose group (received atorvastatin of routine dose, 20mg/d) and double dose group (received atorvastatin of double dose, 40mg/d), and both groups were treated for four weeks. Levels of blood glucose, blood lipids, HbA1c, AGEs and cardiac diastolic function were measured and compared between two groups before and after treatment, and clinical therapeutic effect and safety were assessed. Results: After treatment, total effective rate of double dose group was significantly higher than that of routine dose group (91. 67％ vs. 72. 92％, P=0. 032); compared with routine treatment group after treatment, there were significant reductions in levels of blood glucose, blood lipids [except high density lipoprotein cholesterol (HDL-C)], HbA1c [(7. 58±1. 47) ％ vs. (6. 18±1. 35) ％], AGEs [(12. 45±2. 36) μg/ml vs. (7. 62±1. 54) μg/ml]and mitral early diastolic peak flow velocity/early mitral annulus diastolic peak velocity [E/Ea: (7. 54±1. 36) vs. (5. 27± 1. 09)], and significant rise in HDL-C level and mitral early diastolic peak flow velocity/mitral late diastolic peak flow velocity [E/A: (1. 25±0. 32) vs. (1. 57±0. 41)] in double dose group, P=0. 001 all. There was no significant difference in incidence rate of adverse reactions between two groups, P=0. 712. Conclusion: In DCM patients, double dose atorvastatin can more effectively regulate blood lipid level, reduce serum levels of HbA1c and AGEs, and improve cardiac diastolic function with more significant therapeutic effect.