中国临床药理学杂志

阿托伐他汀在2型糖尿病心肌病患者中的临床研究

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孙继舒 ^1a , 郝赛 ^1a , 陈敏 ^1a , 马红玉 ^1b

中国临床药理学杂志 | 临床与基础桥接研究 2026,42(5): 612-618

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中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (5) : 612 -618

阿托伐他汀在2型糖尿病心肌病患者中的临床研究

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孙继舒^1a, 郝赛^1a, 陈敏^1a, 马红玉^1b

作者信息

^1a.邢台市中心医院内分泌血液科，河北邢台 054000

^1b.邢台市中心医院老年病科，河北邢台 054000

通讯作者:

马红玉，主治医师 MP: 18232112725 E-mail: 664503213@qq.com

作者简介:

孙继舒（1993-），女，主治医师，主要从事内分泌相关的临床工作和研究

Clinical trial of atorvastatin in patients with type 2 diabetes cardiomyopathy

Ji-shu SUN^1a, Sai HAO^1a, Min CHEN^1a, Hong-yu MA^1b

Affiliations

^1a.Department of Endocrinology and Hematology, Xingtai Central Hospital, Xingtai 054000, Hebei Province, China

^1b.Department of Geriatrics, Xingtai Central Hospital, Xingtai 054000, Hebei Province, China

出版时间: 2026-03-17 doi: 10.13699/j.cnki.1001-6821.2026.05.003

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摘要

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目的

观察阿托伐他汀钙片在2型糖尿病心肌病患者中的临床疗效和安全性。

方法

纳入我院治疗的2型糖尿病心肌病患者，依据治疗方案分为试验组和对照组。对照组采用常规治疗；试验组联合阿托伐他汀钙片20 mg·d^-1口服，持续治疗4周。比较2组的心功能、血脂、血糖、自噬相关蛋白及磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白（PI3K/Akt/mTOR）通路相关mRNA表达，并进行安全性评价。

结果

本研究共纳入198例患者，试验组104例、对照组94例。治疗4周后，试验组的临床总有效率为92.31%（96例/104例），显著高于对照组的80.85%（76例/94例）（P<0.05）。治疗后，试验组和对照组的左心室舒张末期直径分别为（54.41±3.87）和（58.62±3.44）mm，左心室舒张末期容积分别为（115.63±8.06）和（121.53±9.88）mL，左心室收缩末期直径分别为（30.34±3.52）和（34.84±3.46）mm，左心室收缩末期容积分别为（69.72±6.32）和（76.57±6.24）mL，左心室射血分数分别为（52.30±5.53）%和（48.52±4.21）%，总胆固醇分别为（4.48±1.32）和（5.92±1.76）mmol·L^-1，甘油三酯分别为（1.75±0.52）和（2.38±0.57）mmol·L^-1，低密度脂蛋白胆固醇分别为（2.49±0.65）和（3.32±1.21）mmol·L^-1，高密度脂蛋白胆固醇分别为（1.02±0.26）和（0.80±0.21）mmol·L^-1，苄氯素1水平分别为（3.28±0.43）和（2.62±0.41）ng·mL^-1，自噬相关基因7水平分别为（6.38±1.07）和（4.60±0.86）ng·mL^-1，PI3K mRNA相对表达水平分别为0.68±0.25和0.94±0.28，Akt mRNA相对表达水平分别为0.58±0.27和0.95±0.30，mTOR mRNA相对表达水平分别为0.66±0.31和0.98±0.32，试验组的上述指标与对照组比较，在统计学上差异均有统计学意义（均P<0.05）。试验组的药物不良反应包括肝功能异常、胃肠道反应和肌痛；对照组有肝功能异常和胃肠道反应。试验组的总药物不良反应发生率为5.77%（6例/104例），对照组为3.19%（3例/94例），在统计学上差异无统计学意义（P>0.05）。

结论

阿托伐他汀片能够显著改善2型糖尿病心肌病患者的心脏结构和功能，调节血脂水平，同时经由促进自噬体形成、下调PI3K/Akt/mTOR通路活性，达到保护心脏的目的。

关键词

阿托伐他汀钙片 / 2型糖尿病心肌病 / 心脏重构 / 磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白信号通路 / 自噬

Abstract

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Objective

To investigate the clinical efficacy and safety of atorvastatin calcium tablets in patients with type 2 diabetes cardiomyopathy.

Methods

Patients with type 2 diabetic cardiomyopathy admitted to our hospital were divided into treatment group and control group according to the treatment methods. The control group received conventional therapy, while the treatment group was administered atorvastatin calcium tablets at 20 mg·d^-1, orally for 4 weeks. The heart function, blood lipids, blood glucose, autophagy-related proteins and the relative expression levels of phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway-related mRNA were compared between the two groups, along with a safety evaluation.

Results

A total of 198 patients were included, with 104 in treatment group and 94 in control group. After 4 weeks of treatment, the total clinical effective rate of treatment group was 92.31% (96 cases/104 cases), significantly higher than control group’s 80.85% (76 cases/94 cases) (P<0.05). After treatment, the left ventricular end diastolic diameter of treatment group and control group were (54.41±3.87) and (58.62±3.44) mm, respectively; the left ventricular end diastolic volume were (115.63±8.06) and (121.53±9.88) mL, respectively; the left ventricular end systolic diameter were (30.34±3.52) and (34.84±3.46) mm, respectively; the left ventricular end systolic volume were (69.72±6.32) and (76.57±6.24) mL, respectively; the left ventricular ejection fraction were (52.30±5.53)% and (48.52±4.21)%, respectively; the total cholesterol were (4.48±1.32) and (5.92±1.76) mmol·L^-1, respectively; triglycerides were (1.75±0.52) and (2.38±0.57) mmol·L^-1, respectively; low-density lipoprotein cholesterol were (2.49±0.65) and (3.32±1.21) mmol·L^-1, respectively; high-density lipoprotein cholesterol were (1.02±0.26) and (0.80±0.21) mmol·L^-1, respectively; the levels of benzyl chloride 1 were (3.28±0.43) and (2.62±0.41) ng·mL^-1, respectively; the levels of autophagy related gene 7 were (6.38±1.07) and (4.60±0.86) ng· mL^-1, respectively; the relative expression levels of PI3K mRNA were 0.68±0.25 and 0.94±0.28, respectively; the relative expression levels of Akt mRNA were 0.58±0.27 and 0.95±0.30, respectively; the relative expression levels of mTOR mRNA were 0.66±0.31 and 0.98±0.32, respectively. The above indicators in treatment group were statistically significant compared with control group (all P<0.05). The adverse drug reactions in treatment group include liver dysfunction, gastrointestinal reactions and muscle pain; the control group had abnormal liver function and gastrointestinal reactions. The total incidence of adverse drug reactions in treatment group was 5.77% (6 cases/104 cases), while in control group was 3.19% (3 cases/94 cases). There was no statistically significant difference between the two groups (all P>0.05).

Conclusion

Atorvastatin tablets can significantly improve cardiac structure and function, and regulate blood lipid levels in patients with type 2 diabetic cardiomyopathy. Additionally, it exerts cardioprotective effects by promoting autophagosome formation and downregulating the activity of the PI3K/Akt/mTOR pathway.

Key words

atorvastatin calcium tablet / type 2 diabetes cardiomyopathy / cardiac remodeling / phosphatidylinositol 3-kinase/protein kinase B/ mammalian target of rapamycin signaling pathway / autophagy

引用本文

孙继舒, 郝赛, 陈敏, 马红玉. 阿托伐他汀在2型糖尿病心肌病患者中的临床研究. 中国临床药理学杂志, 2026 , 42 (5) : 612 -618 . DOI: 10.13699/j.cnki.1001-6821.2026.05.003

Ji-shu SUN, Sai HAO, Min CHEN, Hong-yu MA. Clinical trial of atorvastatin in patients with type 2 diabetes cardiomyopathy[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (5) : 612 -618 . DOI: 10.13699/j.cnki.1001-6821.2026.05.003

基金

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邢台市重点研发计划基金资助项目(2023ZC070)

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2026年第42卷第5期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2026.05.003

接收时间：2025-05-20
首发时间：2026-08-06
出版时间：2026-03-17

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收稿日期：2025-05-20

基金

邢台市重点研发计划基金资助项目(2023ZC070)

作者信息

^1a.邢台市中心医院内分泌血液科，河北邢台 054000

^1b.邢台市中心医院老年病科，河北邢台 054000

通讯作者:

马红玉，主治医师 MP: 18232112725 E-mail: 664503213@qq.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.05.003

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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