摘要
目的研究二甲双胍对糖尿病合并冠状动脉病变的影响。方法 253例糖尿病合并冠心病患者按照随机数字表法分为二甲双胍组(500 mg,3次/天)及吡格列酮组(15 mg,1次/天),疗程12个月。观察血管内皮功能、胰岛B细胞功能、冠状动脉造影的变化。结果与治疗前相比,治疗12个月后两组患者的血糖、胰岛抵抗指数均显著下降,空腹及餐后胰岛素水平、胰岛B细胞功能均显著升高,差异有统计学意义(均P<0.05)。治疗12个月后两组间的血糖、胰岛素抵抗指数、胰岛素水平、胰岛B细胞功能比较,差异均无统计学意义(均P>0.05);但治疗12个月后二甲双胍组的体质量指数低于吡格列酮组,差异有统计学意义(P<0.05)。与治疗前相比,治疗12个月后二甲双胍组的冠状动脉三支病变及弥漫性血管病变发生率较治疗前显著降低,差异有统计学意义(P<0.05),二甲双胍组的冠状动脉三支病变及弥漫性血管病变发生率较吡格列酮组显著降低,差异有统计学意义(P<0.05)。结论二甲双胍与吡格列酮对2型糖尿病患者均具有明显的降糖、改善胰岛功能、降低胰岛素抵抗的作用。在降低体质量指数及改善糖尿病合并冠状动脉病变方面,二甲双胍优于吡格列酮组。
Objective To study metformin effects on macrovascular lesion of coronary artery in patients with type 2 diabetes mellitus complicated with coronary heart disease. Methods 253 patients with type 2 diabetes mellitus complicated with coronary heart disease were randomly （random number table method） assigned to mefformin group （500 rag,3 times/d） and pioglitazone group （15 mg,l time/d） ,the course of 12 months. Then observe the changes of macrovaseular lesion of coronary artery. Results Compared with those before treatment, blood sugar, insulin resistance index were lower than those after 12 months of treatment, fasting and postprandial insulin levels, insulin function index were higher than those after 12 months of treatment, and the difference was statistically significant （all P 〈 0.05 ）. After 12 months of treatment ,the difference of blood glucose, insulin resistance index, insulin levels, insulin function between two groups was not statistically significant （ all P 〉 0.05 ）. But after 12 months of treatment, body mass index in metform- in group was less than those in pioglitazone group, the difference was statistical significance（ P 〈 0.05 ）. Mefformin group after 12 months of treatment has lower extent of coronary vessel involvement and less diffuse vascular lesions than those before treatment,the difference was statistical significance （P 〈 0.05 ）. After 12 months of treatment, metformin group had lower extent of coronary vessel involvement and less diffuse vascular lesions than pioglitazone group, the difference was statistical significance（ P 〈 0.05 ）. Conclusion Both mefformin and pioglitazone in patients with type 2 diabetes mellitus complicated with coronary heart disease can significantly decrease blood sugar,improve insulin function,reduce the role of insulin resistance. In the lowering body mass index and decreasing macrovascular lesion of coronary artery, mefformin is be superior to pioglitazone.
出处
《中国临床保健杂志》
CAS
2017年第4期389-392,共4页
Chinese Journal of Clinical Healthcare
