罗格列酮对2型糖尿病患者冠脉支架内再狭窄的预防作用

Preventative effects of rosiglitazone for in-stent restenosis after percutaneous coronary intervention in patients with type 2 diabetes

目的探讨罗格列酮对2型糖尿病患者行冠脉成形及支架植入术后支架内再狭窄的预防作用。方法选择行冠脉成形及支架植入术的2型糖尿病患者60例。在原有降糖药物治疗的基础上,研究组(n=31)加服罗格列酮;对照组(n=29)用药方案不变。术后随访6 mo,观察患者死亡、急性心肌梗死及再次血管重建术等心血管事件的发生情况,在随访结束时行活动平板检查,结果阳性的再次行选择性冠脉造影术。结果2组患者随访期间均无死亡、急性心肌梗死等心血管事件发生。6 mo内研究组9例再次心绞痛发作,5例活动平板试验阳性,其中5例(16.1%)冠脉支架内再狭窄;而对照组18例再次心绞痛发作,其中15例活动平板阳性,15例(48.4%)冠脉造影术证实支架内再狭窄,2组再狭窄对比有显著差异(P=0.013)。结论对于2型糖尿病合并冠心病行冠脉成形及支架植入术患者,罗格列酮能有效降低支架内再狭窄。

AIM To investigate the effects of rosiglitazone for in-stent restenosis after percutaneous coronary intervention(PCI) in type 2 diabetes mellitus patients with coronary heart disease. METHODS To be the study group, a total of 31 diabetes patients with unstable angina(UA) (male 19 , female 12, age 42-75 a), were underwent PCI and stenting. All the patients accepted rosiglitazone(TZDs) at least 6 mo after the procedure, combined with conventional antidiabetic therapy . The control group was formed from a well matched population of 29 diabetes patients with UA according to the sex, age and the other risk factors of coronary heart disease. They were underwent PCI and stenting, but just took conventional antidiabetic therapy(no TZDs). After a 6-months follow-up, the treadmill exercise test would be done. If it got a positive treadmill exercise test result,the selective angiography would be done. RESULTS There was not dead case and acute myocardial infarction within the period of follow-up. There were 18 cases with angina in the control group, but only 9 cases in the study group. The data of the treadmill exercise test showed a positive result in 5 cases in study group, but there were 15 cases in control group. By the data of selective angiography, there were 5 cases(16.1%) found in-stent restenosis in the study group, but 15 cases(48.4%)in the control group. There significant difference in 2 groups (P=0.013). CONCLUSION The in-stent restenosis could be significant reduces by treatment with rosiglitazone in diabetic patients with CAD who underwent coronary stent implantation.