吡格列酮缩小糖耐量异常患者冠状动脉斑块面积的临床研究

目的:观察吡格列酮对糖耐量异常合并冠状动脉(冠脉)临界病变患者冠脉斑块、血清高敏C反应蛋白(hsCRP)、脂联素和血浆内皮素-1(ET-1)水平的影响.方法:28例患者随机分为吡格列酮组(n=15)和对照组(n=13).对照组给予常规治疗,吡格列酮组在常规治疗基础上给予吡格列酮15 mg/d,分别于治疗前和治疗6个月后检测血清hsCRP、脂联素和血浆ET-1水平,以血管内超声检测斑块负荷、斑块面积和斑块成分.结果:治疗6个月后,吡格列酮组患者与对照组相比冠脉斑块负荷和斑块面积均显著降低,薄纤维帽斑块比例降低、斑块中坏死成分所占比例降低(P均<0.05),差异均有统计学意义.治疗后吡格列酮组hsCRP和ET-1水平显著降低、脂联素水平升高,与治疗前比差异均有统计学意义(P均<0.05).血清脂联素与ET-1水平和冠脉斑块面积均呈显著负相关(r值分别为-0.739和-0.431,P均<0.05).结论:糖耐量异常合并冠脉临界病变患者,在常规治疗基础上加用吡格列酮口服,可以缩小并稳定斑块,其机制可能与升高脂联素水平、改善内皮功能、抑制炎症反应有关.

Pioglitazone Regresses Coronary Plaques in Patients of Impaired Glucose Tolerance Combined With Coronary Borderline Lesions

Objective;To observe the effect of pioglitazone on coronary plaques and serum high sensitivity C-reactive protein(hs-CRP), adiponectin and plasma ET-1 levels in patients of impaired glucose tolerance combined with coronary borderline lesions. Methods-.A total of 28 patients treated in our hospital were randomly divided into two groups;Pioglitazone group,n= 15,the patients received pioglitazone 15 mg/d with routine medication,and Control group,n= 13,the patients received routine medication. Coronary plaque a...