罗格列酮对冠心病患者胰岛素抵抗及炎症因子的影响

目的探讨罗格列酮对冠心病患者胰岛素抵抗及炎症因子的影响。方法 56例冠心病患者分为两组,对照组给予常规治疗,治疗组在常规治疗基础上给马来酸罗格列酮4 mg/d,测定治疗前后血脂、空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、TNF-α及hs-CRP等指标的变化,采用自我平衡模型分析法（HOMA）计算胰岛素抵抗指数（IRI）。结果治疗组在治疗后血脂、FPG、FINS、HbA1c、IRI、TNF-α及hs-CRP水平较治疗前及对照组均有下降（P〈0.01或P〈0.05）,且相关性分析显示治疗组治疗后TNF-α及hs-CRP下降与IRI下降呈正相关（r=0.387、0.426,均P〈0.05）。结论在冠心病患者中应用罗格列酮治疗,不仅可以改善其糖脂代谢及胰岛素抵抗,还可降低患者体内炎症因子水平,可能对冠心病患者的预后有益。

Effects of Rosiglitazone on insulin resistance and inflammation factors in patients with coronary heart disease

Objective To evaluate the effects of Rosiglitazone on insulin resistance(IR) and inflammation factors in patients with coronary heart disease(CHD).Methods 56 patients with CHD were divided into two groups,both the control group and the therapeutic group were given conventional therapy,and Rosiglitazone Maleate 4 mg was added to the therapeutic group.The changes of blood lipids,fasting plasma glucose(FPG),fasting insulin(FINS),HbA1c,TNF-α and hs-CRP before and after therapy were compared.Homeostasis model assessment(HOMA) index was used for quantitative analysis of insulin resistance index(IRI).Results After therapy,the levels of blood lipids,FPG,FINS,HbA1c,IRI,TNF-α and hs-CRP in the therapeutic group decreased significantly compared with the pre-treatment and those in the control group(P < 0.01 or P < 0.05).Correlation analysis showed the decreasing of IL-6 and hs-CRP were positively correlated with the decrease of IRI(r = 0.387,0.426,all P < 0.05).Conclusion The use of Rosiglitazone not only can improve glucose metabolism,lipid metabolism and IR but also decrease the levels of inflammatory factors.It may have some good effects on prognosis of the patients with CHD.