吡格列酮对非糖尿病患者冠状动脉药物洗脱支架内再狭窄的影响

目的探讨吡格列酮对非糖尿病患者冠状动脉（冠脉）支架内再狭窄的影响及其可能的机制。方法选择置入雷帕霉素药物洗脱支架的非糖尿病患者,随机分成治疗组48例和对照组41例,治疗组在对照组常规治疗的基础上加用吡格列酮（30mg,qd）。冠脉支架置入术后6～8个月行选择性冠脉造影术,并于治疗前及随访6～8个月复查时分别测定血脂、空腹血糖,空腹胰岛素,并计算胰岛素抵抗指数（HOMA-IR）。结果冠脉支架置入术后6～8个月,治疗组支架内再狭窄的患者0例（0%）,对照组5例（12.20%）,两组比较有统计学差异（P〈0.05）。两组患者术后6～8个月分别与治疗前比较,血脂指标均明显降低（P〈0.05或P〈0.01）,空腹血糖均无明显变化（P〉0.05）,HOMA-IR治疗组较治疗前明显降低（P〈0.01）,而对照组无明显变化（P〉0.05）。治疗组与对照组比较,血脂指标、空腹血糖在治疗前及术后6～8个月均无显著性差异（P均〉0.05）,而HOMA-IR在治疗前无显著性差异（P〉0.05）,术后6～8个月治疗组却较对照组降低（P〈0.05）。结论吡格列酮可以防止非糖尿病患者药物洗脱支架的再狭窄,增加胰岛素敏感性,可能是吡格列酮防止洗脱支架内再狭窄的机制之一。     

吡格列酮对2型糖尿病并发心血管病患者血清脂联素与胰岛素抵抗的影响

目的探讨吡格列酮对2型糖尿病并发心血管病患者血清脂联素与胰岛素抵抗(IR)的影响。方法随机选取2型糖尿病合并冠心病患者60例,正常对照组30例。分别检测血清脂联素、瘦素、肿瘤坏死因子(TNF-α)、游离脂肪酸(FFA)、空腹血糖(FPG)和胰岛素、体重指数(BMI)、血压(BP)、总胆固醇(TC)、甘油三酯(TG)等指标,计算胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMA-IR)。再将60例2型糖尿病并发心血管病患者分成2组,吡格列酮治疗组32例,常规治疗组28例,吡格列酮治疗组用吡格列酮治疗8w,治疗前后均检上述指标。结果(1)2型糖尿病合并冠心病患者与对照组比较,血清脂联素水平降低(P<0.01),吡格列酮治疗组与常规治疗组比较,血清脂联素无差异(P>0.05);(2)应用吡格列酮治疗后,患者血清脂联素水平显著升高(P<0.01),TNF-α、FFA、胰岛素水平下降(P<0.01),IR明显改善。结论吡格列酮能增加2型糖尿病并发心血管病患者血清脂联素水平,改善IR。     

吡格列酮对2型糖尿病患者血清脂联素的影响及其意义

目的 探讨吡格列酮对2型糖尿病(T2DM)患者血清脂联素水平影响.方法 用ELISA法检测67例T2DM患者和52例非糖尿病对照组的血清脂联素水平,用随机双盲法比较47例T2DM患者用安慰剂和吡格列酮干预治疗8 w后的血清脂联素、血糖、胰岛素抵抗(IR)水平.结果 T2DM患者组与对照组比较,血清脂联素水平降低(P<0.05);应用吡格列酮治疗后,患者血清脂联素水平显著升高(P<0.05),血糖降低(P<0.05),IR明显改善,而常规组治疗前后无显著性差异(P>0.05).结论 吡格列酮能提高2型糖尿病患者血清脂联素水平,降低血糖水平及改善胰岛素抵抗.     

吡格列酮联合二甲双胍对2型糖尿病患者胰岛素抵抗及脂肪细胞因子水平的影响

目的观察吡格列酮联合二甲双胍治疗2型糖尿病(T2DM)的疗效,探讨治疗对患者胰岛素抵抗及脂肪细胞因子水平的影响。方法将我院收治的T2DM患者72例随机分为观察组和对照组,每组36例。对照组给予口服二甲双胍治疗,观察组给予二甲双胍联合盐酸吡格列酮治疗。观察两组患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(F-INS)和胰岛素抵抗指数(Homa IR)。并应用酶联免疫吸附法(ELISA)检验两组治疗前后血浆瘦素和脂联素水平。结果治疗后两组患者FPG、2 h PBG、HbA1c和Homa IR均显著降低(均P<0.05);治疗后研究组2 h PBG、HbA1c和Homa IR显著低于对照组(均P<0.05);治疗前两组瘦素和脂联素比较无统计学差异(均P>0.05),治疗结束后两组患者血清瘦素均显著降低,血清脂联素显著升高(均P<0.05),研究组血清瘦素显著低于对照组,血清脂联素显著高于对照组(P<0.05)。结论吡格列酮联合二甲双胍治疗可以有效调节T2DM患者瘦素和脂联素水平,进一步改善患者胰岛素抵抗。     

吡格列酮对高脂大鼠非酒精性脂肪肝与胰岛素抵抗的影响

目的探讨环境因素引起的非酒精性脂肪肝与胰岛素抵抗的关系,并观察吡格列酮对其的影响。方法应用59％高脂饮食喂养大鼠4周制成胰岛素抵抗的动物模型后,给予药物吡格列酮干预4周,观察非酒精性脂肪肝对大鼠胰岛素敏感性的影响以及吡格列酮对其的干预。结果经59％高脂饮食喂养8周后,模型对照组较正常对照组大鼠空腹血糖及胰岛素均明显增高,血脂、血清游离脂肪酸（FFA）亦明显增高。而给予吡格列酮干预后药物干预组较模型对照组大鼠空腹血糖及胰岛素均明显减低,血脂、血清FFA亦明显减低。结论高脂饮食可诱导非酒精性脂肪肝并导致胰岛素抵抗,而吡格列酮可干预此过程。     

预防性应用吡格列酮改善胰岛素抵抗的脂肪内分泌机制

目的探讨吡格列酮改善胰岛素抵抗过程中脂肪内分泌功能的改变。方法45只W istar雄性大鼠随机分为对照组、胰岛素抵抗组和吡格列酮组。胰岛素抵抗动物模型成功建立后,分析各组抵抗素、脂联素和脂联素受体的表达。结果与胰岛素抵抗组比较,吡格列酮组大鼠的体质量、空腹血糖、游离脂肪酸差异不明显,但胰岛素、胰岛素抵抗指数、葡萄糖耐量和胰岛素耐量明显改善（P〈0.01）,脂联素表达明显增高（P〈0.05）。结论脂肪内分泌功能紊乱在高脂诱导胰岛素抵抗的发生中起着重要的作用,预防性应用吡格列酮可明显延缓大鼠胰岛素抵抗的发生,改善脂肪内分泌功能。     

初发2型糖尿病患者血脂联素和瘦素与胰岛素抵抗的关系

目的 研究初发2型糖尿病患者血脂联素和瘦素水平的变化及其与胰岛素抵抗的关系.方法 选择46例初发2型糖尿病患者,及与其体脂含量相匹配的糖耐量正常者43名,计算体重指数(BMI)和腰臀围比(WHR),并空腹采血,测定血糖(FPG)、血脂、真胰岛素(FTI)、胰岛素原(FPI)、脂联素和瘦素浓度,分析血清脂联素和瘦素水平的变化及其与胰岛素抵抗的关系.用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗程度.结果 2型糖尿病组与正常对照组比较,年龄、BMI无统计学意义(P>0.05),三酰甘油、FPG及FPI和HOMA-IR明显升高(P<0.05或P<0.01),舒张压、脂联素水平明显降低(P<0.05或P<0.01);相关分析显示,脂联素与FPG、FTI、HOMA-IR、BMI、WHR呈负相关(P<0.05或P<0.01);瘦素与BMI、FTI、HOMA-IR、FPG呈正相关(P<0.05或P<0.01),与WHR无关.人血清脂联素和瘦素间无相关性.结论 人血清脂联素和瘦素与胰岛素抵抗密切相关,体脂含量相同的初发2型糖尿病患者血脂联素水平低于正常人.     

吡格列酮配合生活方式干预对SHR大鼠糖脂代谢的影响

目的探索胰岛素增敏剂吡格列酮配合生活方式干预对自发性高血压大鼠(SHR)糖脂代谢的影响。方法 SHR大鼠44只,随机分为4组:SHR对照组,吡格列酮组,吡格列酮配合生活方式组,硝苯地平配合生活方式组。吡格列酮添加到大鼠饮水中。生活方式干预为每日控制进食量并游泳6～15min,实验周期为12w。实验结束时测量大鼠血脂、空腹血糖及血清胰岛素水平并计算胰岛素分泌指数(HOMA-β)及胰岛素抵抗指数(HOMA-IR)。结果与SHR对照组相比,吡格列酮配合生活方式干预均能降低SHR大鼠空腹血糖,提高HOMA-β(P0.05),降低HOMA-IR(P0.01);单纯应用吡格列酮能降低SHR大鼠甘油三酯及空腹血糖,提高HOMA-β(P0.05);硝苯地平配合生活方式干预能低降低SHR大鼠甘油三酯及空腹血糖(P0.05)。吡格列酮配合生活方式干预降压效果优于单纯应用吡格列酮(P0.05),其降低HOMA-IR优于硝苯地平(P0.05)。结论吡格列酮及配合生活方式干预可较好的调整糖脂代谢,减轻动脉粥样硬化发生的危险因素,其调脂效果好于钙离子拮抗剂。     

吡格列酮对2型糖尿病大鼠骨骼肌脂联素受体1表达的影响

目的观察吡格列酮对2型糖尿病大鼠血清脂联素以及骨骼肌脂联素受体1(AdipoR1)表达的影响,探讨吡格列酮对2型糖尿病胰岛素抵抗的改善作用及机制。方法 40只8周龄健康雌性SD大鼠,随机分为正常对照组(n=10)、糖尿病组(n=15)及吡格列酮组(n=15)。用高糖高脂饲料加小剂量链脲佐菌素建立2型糖尿病大鼠模型,成模后吡格列酮组给予10 mg/(kg.d)吡格列酮灌胃,正常对照组和糖尿病组给予同体积生理盐水灌胃,共12周。3个月后股静脉取血,酶联免疫吸附法(ELISA)测定血清脂联素水平,留取大鼠骨骼肌,光、电镜观察骨骼肌结构,免疫组织化学染色法测定骨骼肌AdipoR1蛋白的表达。结果与正常对照组(1.73±0.32 mg/L)比较,糖尿病组血清脂联素(1.01±0.27 mg/L)水平显著降低,而吡格列酮组(1.34±0.43 mg/L)较糖尿病组显著升高,差异有统计学意义(P<0.05)。骨骼肌AdipoR1免疫组织化学染色正常对照组着色深且广泛,糖尿病组较正常对照组染色浅,吡格列酮组较糖尿病组染色深,但较正常对照组浅。光镜及电镜结果显示大鼠骨骼肌结构未见明显异常。结论 2型糖尿病大鼠血清脂联素水平及骨骼肌AdipoR1表达降低并导致糖脂代谢紊乱及胰岛素抵抗。吡格列酮可上调血清脂联素及骨骼肌AdipoR1的表达,从而调节糖脂代谢,改善胰岛素抵抗。     

吡格列酮对2型糖尿病患者血清视黄醇结合蛋白4和网膜素1的影响

目的 观察吡格列酮对2型糖尿病患者血清视黄醇结合蛋白4(RBP4)和网膜素1的影响.方法 选择80例新诊断2型糖尿病患者,随机分为对照组和吡格列酮组,每组40例,治疗3个月.比较两组患者治疗前后空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)及血清BBP4和网膜素1的水平变化.结果 与对照组比较,吡格列酮组治疗后FPG和HOMA-IR明显降低(P＜0.05),血清RBP4水平也明显降低(P＜0.01),而网膜素1水平明显升高(P＜0.01).Pearson相关分析显示,RBP4与FPG、体质指数及HOMA-IR呈正相关,与低密度脂蛋白呈负相关(P＜0.05);网膜素1与低密度脂蛋白呈正相关,与FPG、体质指数及HOMA-IR呈负相关(P＜0.05).结论 吡格列酮可能通过调节血清RBP4和网膜素1水平而改善胰岛素抵抗.     

Insulin resistance in nondiabetic patients with acute myocardial infarction.

BACKGROUND: Recent studies have shown that insulin resistance (IR) is an independent predictor of early restenosis after coronary stenting. The aim of this study was to examine the effects of IR and its linkage to late loss with bare metal stenting in nondiabetic patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We enrolled 61 nondiabetic patients with AMI who have undergone coronary stenting. Quantitative analyses of coronary angiographic data before and after the procedure and at 4 months were performed. Fasting plasma glucose (FPG) and insulin were measured every week until the subjects' hospital discharge. Stress hormones, endothelial nitric oxide synthase, tumor necrosis factor alpha, interleukin-6, leptin, and adiponectin were measured on admission and at 4 months after coronary stenting. RESULTS: Simple linear regression analyses showed a relationship between FPG and insulin [IR group: r=0.297, P=.0428; no insulin resistance (NIR) group: r=0.539, P=.0466] and that late loss was associated with the homeostasis model assessment of IR (HOMA-IR) at 4 months (r=0.435, P=.03). At multiple regression analyses, HOMA-IR on admission in the IR group significantly correlated with thyroid-stimulating hormone, glucagon, and cortisol. The HOMA-IR at 4 months correlated with leptin. CONCLUSIONS: Nondiabetic patients with AMI can be classified into two groups: the IR group and the NIR group. The IR consisted of the transient IR, which correlated with stress hormones, and the continuous IR, which correlated with leptin and contributed to restenosis after coronary stenting.     

Comparison of metabolic profile and adiponectin level with pioglitazone versus voglibose in patients with type-2 diabetes mellitus associated with metabolic syndrome

Type 2 diabetes mellitus (T2DM) associated with metabolic syndrome (MetS) represents a high risk of cardiovascular disease. We compared the effect of early intervention with pioglitazone versus voglibose on physical and metabolic profiles and serum adiponectin level in patients with T2DM associated with MetS. Sixty patients who were diagnosed for the first time as T2DM associated with MetS were analyzed for insulin sensitivity, lipid profile, serum adiponectin and systemic inflammation. Those patients were randomly assigned to oral pioglitazone group (n = 30) or voglibose group (n = 30) in addition to conventional diet and exercise training. Body mass index and waist circumference did not change in the pioglitazone group, whereas these physical parameters significantly decreased in the voglibose group during a 6-month follow-up period. However, glycosylated hemoglobin, fasting plasma glucose, and HOMA-IR more significantly decreased in the pioglitazone group. The level of serum adiponectin especially high-molecular weight adiponectin markedly increased in the pioglitazone group. Moreover, high sensitive CRP significantly decreased only in the pioglitazone group. These results suggest that voglibose is superior in improving obesity, while pioglitazone is superior in ameliorating insulin sensitivity and increasing serum adiponectin in patients with an early stage of T2DM associated with MetS.     

Remnant-like lipoprotein particle level and insulin resistance are associated with in-stent restenosis in patients with stable angina

BACKGROUND: The aim of this study was to evaluate the independent effect of serum remnant-like lipoprotein particle level and insulin resistance on in-stent restenosis in nondiabetic patients with stable angina. METHODS: The study included 64 nondiabetic patients with stable angina who underwent successful coronary stenting. At the time of stenting, we evaluated the patients' lipid profiles including remnant-like lipoprotein particles cholesterol, plasma glucose and insulin levels, and insulin resistance by the homeostasis model assessment. RESULTS: There was no significant difference in total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels between two patient groups with (n=15) and without (n=49) in-stent restenosis. Plasma remnant-like lipoprotein particles cholesterol level was significantly higher in patients with restenosis than in patients without restenosis (8.2+/-7.0 mg/dl vs. 4.5+/-2.6 mg/dl, P=0.006). Although plasma glucose level was similar between the two groups, insulin level and homeostasis model assessment were significantly higher in patients with restenosis, compared with those without restenosis (11.2+/-12.4 vs. 7.1+/-2.8, P=0.039; and 2.6+/-2.9 vs. 1.7+/-0.7, P=0.040, respectively). In multivariate logistic regression analysis, plasma remnant-like lipoprotein particles cholesterol level (>4.8 mg/dl; the 75th percentile of the distribution of remnant-like lipoprotein particles cholesterol level) was the independent predictor of in-stent restenosis (odds ratio: 8.15; confidence interval: 1.02-65.16; P=0.048). CONCLUSIONS: Our findings suggest that high serum remnant-like lipoprotein particles cholesterol level, and not insulin resistance may be an independent risk factor on in-stent restenosis in nondiabetic patients with stable angina.     

Impact of Insulin Resistance on Neointimal Tissue Proliferation after 2nd-Generation Drug-Eluting Stent Implantation

Percutaneous coronary intervention is established as an effective treatment for patients with ischemic heart disease; in particular, drug-eluting stent implantation is known to suppress in-stent restenosis. Diabetes mellitus is an independent risk factor for restenosis, so reducing insulin resistance is being studied as a new treatment approach. In this prospective study, we sought to clarify the factors associated with in-stent restenosis after percutaneous coronary intervention, and we evaluated the homeostasis model assessment of insulin resistance (HOMA-IR) index as a predictor of restenosis.We enrolled 136 consecutive patients who underwent elective percutaneous coronary intervention at our hospital from February 2010 through April 2013. All were implanted with a 2nd-generation drug-eluting stent. We distributed the patients in accordance with their HOMA-IR index values into insulin-resistant Group P (HOMA-IR, ≥2.5; n=77) and noninsulin-resistant Group N (HOMA-IR, <2.5; n=59). Before and immediately after stenting, we measured reference diameter, minimal lumen diameter, and percentage of stenosis, and after 8 months we measured the last 2 factors and late lumen loss, all by means of quantitative coronary angiography.After 8 months, the mean minimal lumen diameter was smaller in Group P than that in Group N (1.85 ± 1.02 vs 2.37 ± 0.66 mm; P=0.037), and the mean late lumen loss was larger (0.4 ± 0.48 vs 0.16 ± 0.21 mm; P=0.025). These results suggest that insulin resistance affects neointimal tissue proliferation after 2nd-generation drug-eluting stent implantation.     

Comparison of bare metal stent with pioglitazone versus sirolimus-eluting stent for percutaneous coronary intervention in patients with Type 2 diabetes mellitus

BackgroundDrug-eluting stents (DESs) have been shown to decrease restenosis as compared with bare-metal stents. Recently, thiazolidinediones effectively reduced restenosis and the risk of repeat target vessel revascularization. We conducted a study to compare the performance of a DES with that of a bare-metal stent with pioglitazone in patients with Type 2 diabetes mellitus (DM).MethodsThe study was a prospective cohort trial involving 38 Type 2 diabetic patients referred for coronary stenting who were assigned to either the sirolimus-eluting stent (SES) group or the pioglitazone group. Quantitative coronary angiography was performed at study entry and at 6 months of follow-up to evaluate in-stent late luminal loss and the percentage of the luminal diameter and the rate of restenosis. We also analyzed major adverse cardiac events (MACE) at 12 months.ResultsThere were no significant differences in glycemic control levels or in lipid levels in the two groups at follow up. The insulin and homeostasis model assessment insulin resistance at follow-up were significantly lower in the pioglitazone group than in the SES group. The percentage of restenosis was similar between the SES group and the pioglitazone group. The incidence of MACE at 1 year tended to be lower in the pioglitazone group than in the SES group.ConclusionsThe bare-metal stent with pioglitazone is not inferior to the SES in the present study and is one of therapeutic strategies of percutaneous coronary intervention for patients with DM.     

Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus

OBJECTIVE: This prospective study evaluates the effect of insulin sensitizers, pioglitazone (PGZ) and metformin (MET) on plasma adiponectin and leptin levels in subjects newly diagnosed with type 2 diabetes mellitus (T2DM). DESIGN: Double blind, randomized, active control, dose escalation study of 12 weeks treatment duration. PATIENTS: Thirty apparently healthy, treatment-naive T2DM patients diagnosed within the past 6 months. MEASUREMENTS: Plasma adiponectin and leptin levels were estimated by enzyme-linked immunosorbent assay (ELISA), and insulin resistance by the homeostasis model of assessment (HOMA-IR). RESULTS: Baseline plasma levels of adiponectin were lower in diabetic (n = 30) subjects than matched controls (n = 10, 6.6 +/- 1.1 vs 10.4 +/- 4.2 microg/ml, P = 0.021). The 12-week treatment with PGZ significantly increased adiponectin concentrations (6.6 +/- 1.1-17.9 +/- 7.4 microg/ml, P < 0.001) with no alteration in the MET treated group (6.8 +/- 1.5-6.7 +/- 2.8 microg/ml, P = 0.9). A significant decrease in plasma leptin levels was observed in the MET treated group (32.0 +/- 28.9-21.4 +/- 23.3 ng/ml, P = 0.024) but not in the PGZ treated group (23.9 +/- 24.1-22.4 +/- 25.4 ng/ml, P = 0.69). The alterations in plasma adiponectin and leptin levels were not associated with any change in body mass index (BMI). PGZ therapy improved insulin sensitivity to a greater degree (P = 0.007 and P = 0.001 for fasting plasma insulin (FPI) and HOMA-IR, respectively) than MET (P = 0.75 and P = 0.02 for FPI and HOMA-IR, respectively) but this improvement was not significantly different from that of MET at the end of 12 weeks (P = 0.146 and P = 0.09 for FPI and HOMA-IR, respectively). However, improvement in insulin sensitivity with PGZ was not commensurate with the increase in adiponectin. Better control of postbreakfast plasma glucose (PBPG) as well as decrease in serum triglycerides (TGs) were also seen with PGZ (PBPG, P < 0.001; TGs, P = 0.013). The rest of the parameters were comparable. Adverse reactions reported were minor and did not result in treatment discontinuation. CONCLUSIONS: Pioglitazone therapy appears to be better in achieving glycaemic control and increasing plasma adiponectin and insulin sensitivity in newly detected type 2 diabetics.     

Efficacy and safety of low-dose pioglitazone after primary coronary angioplasty with the use of bare metal stent in patients with acute myocardial infarction and with type 2 diabetes mellitus or impaired glucose tolerance

Thiazolidinediones (TZDs) have beneficial effects on markers of cardiovascular risk in patients with type 2 diabetes mellitus (DM). This study aimed to investigate the efficacy and safety of low-dose pioglitazone (15 mg per day) in patients with acute myocardial infarction (AMI) and type 2 DM or impaired glucose tolerance (IGT) treated with coronary angioplasty using bare metal stent (BMS). In 56 patients, pioglitazone was orally administered for 6 months after stenting (pioglitazone group). The incidence of in-stent restenosis (ISR) and left ventricular end-diastolic volume index (LVEDVI) at acute phase and 6 months after stenting in these patients were retrospectively compared with those in the other 37 patients (control group) treated without pioglitazone. No adverse events including death, emergency bypass surgery, and reinfarction, occurred in any patients in the hospital. There was no congestive heart failure (CHF) during a follow-up period in the pioglitazone group. At 6 months after stenting, the overall angiographic ISR rate was significantly lower in the pioglitazone group than in the control group (28.6% vs 48.6%, P = 0.049). In patients with hemoglobin A1c (HbA1c) <7.0% at follow-up, the ISR rate was also significantly lower in the pioglitazone group than in controls (21.3% vs 44.8%, P = 0.03). Delta-LVEDVI (defined as follow-up LVEDVI minus acute LVEDVI) was similar between the pioglitazone group and control group (0.13 vs 5.16 ml/m², P = 0.482). Low-dose pioglitazone seems to have a potential to reduce ISR and does not adversely affect LV remodeling after AMI treated with coronary angioplasty using BMS in patients with type 2 DM or IGT.     

芪参益气滴丸联合阿托伐他汀对冠状动脉内支架再狭窄的干预

目的 探讨芪参益气滴丸联合阿托伐他汀对冠状动脉内支架再狭窄的干预作用.方法 纳入冠脉内支架置入术成功的141例冠心病患者,随机分为对照组（n=30）、芪参益气滴丸组（芪参组,n=36）、阿托伐他汀组（n=36）、和联合组（阿托伐他汀＋芪参益气滴丸,n=39）,药物治疗疗程均为6个月.采用冠状动脉定量分析支架术前、术后狭窄病变管腔内径和面积指标,评价阿托伐他汀、芪参益气滴丸及联合用药对支架内再狭窄的作用.结果 共有85例患者及108处支架在术后6个月内进行冠脉造影复查.四组患者随访时间及随访率比较,差异无统计学意义（P＞0.05）.芪参组、阿托伐他汀组、联合组支架内再狭窄率均低于对照组（P＜0.05）.联合组、阿托伐他汀组在晚期内径丢失、晚期内径丢失指数均小于对照组和芪参组（P＜0.05～0.01）;在支架置入血管段最小内径、净内径获得、净内径获得指数、管腔面积净获得方面均大于对照组和芪参组（P＜0.05～0.01）.联合组晚期内径丢失、晚期内径丢失指数、再狭窄率呈小于阿托伐他汀组趋势,而支架置入血管段最小内径、净内径获得、净内径获得指数、管腔面积净获得方面呈大于阿托伐他汀组趋势,但两组上述指标差异无统计学意义（P＞0.05）.结论 芪参益气滴丸联合阿托伐他汀对支架内再狭窄的防治有协同作用.