吡格列酮对冠心病合并糖耐量异常患者冠脉支架内再狭窄的影响.docVIP

吡格列酮对冠心病合并糖耐量异常患者冠脉支架内再狭窄的影响 　　作者：李日健,李上海,吴铿　　作者单位：广东医学院附属医院心内科，广东湛江524001 　　【摘要】目的 观察吡格列酮对冠心病合并糖耐量异常患者冠脉支架内再狭窄的影响。方法 本组97例均为冠心病合并糖耐量异常在我院接受冠脉药物支架置入术的患者，随机分为两组：吡格列酮组(n=46)接受吡格列酮(15mg/d)和基础治疗;对照组(n=51)只接受基础治疗。两组术后均随访6个月,记录支架内再狭窄率和心血管事件发生率。结果 在随访期内两组支架内再狭窄发生率,吡格列酮组为(0.51±0.11)%,对照组为(2.84±0.48)%，两组比较差异有统计学意义(P0.05);心血管事件发生率，吡格列酮组也比对照组有显著降低。结论 冠心病合并糖耐量异常患者置入支架后服用吡格列酮能有效降低支架内再狭窄和减少心血管事件的发生。 　　【关键词】 吡格列酮,糖耐量异常,支架内再狭窄 　　Abstract: Objective To observe the effects of pioglitazone on stent restenosis in coronary heart disease patients with impaired glucose tolerance. Methods Ninetyseven percutaneous coronary intervention (PCI) patients with impaired glucose tolerance from March 2006 to March 2008 were randomly divided into pioglitazone group (n=46) receiving conventional therapy plus medication pioglitazone (15mg/day), and control group (n=51) merely receiving conventional therapy. The groups were followed up for six months after operation. The stent restenosis rate and cardiovascular event rate were recorded. Results During the followup period, the stent restenosis rates were (0.51±0.11) in the pioglitazone group and (2.84±0.48) in the control group, with a significant difference, P0.05; the cardiovascular events rate were significantly lower in the pioglitazone group than in the control group. Conclusion For the coronary heart disease patients with impaired glucose tolerance, taking pioglitazone after coronary stent implantation may reduce stent restenosis and the occurrence of cardiovascular events. 　　Key words:pioglitazone; impaired glucose tolerance; stent restenosis 　　目前冠状动脉内药物支架植入术已经越来越多地应用于临床,但药物支架术后支架再狭窄(instent restenosis, IR)或支架管腔丢失仍然有发生，特别是冠心病合并糖耐量异常患者。胰岛素抵抗与冠心病的发生有密切关系，Rosmarkis等[1]用Meta分析发现噻唑烷二酮类药物可减少冠状动脉介入治疗术后IR的发生;尹朝霞等[2]用相关分析表明：胰岛素抵抗与冠心病的关系非常密切,但对其防治的意义尚不清楚。本文是观察吡格列酮对冠心病合并糖耐量异常患者冠脉支架内再狭窄的影响,现将结果报道如下。 　　1 资料和方法 　　1.1 一般资料 　　2006年3月至2008年3月于我院行冠状动脉造影证实冠状动脉的直径狭窄程度75%接受支架植入术和胰岛素抵抗指数2.8的患者112例。112例中属稳定型心绞痛28例和急性冠脉综合征包括不稳定型心绞痛及