阿卡波糖干预老年心肌梗死并糖耐量减低患者的疗效及安全性研究

Effect and safety of Acarbose on elderly patients with acute myocardial infarction complicating impaired glucose tolerance

目的探讨阿卡波糖干预对合并糖耐量减低(IGT)的老年急性心肌梗死(AMI)患者预后的影响及其安全性。方法 105例合并IGT的老年AMI患者随机分为干预组(53例)和对照组(52例)。两组给予相同基础治疗,干预组同时加予阿卡波糖(50 mg,3次/d)治疗,平均随访1.8年,观察两组再发心血管事件的情况、颈动脉内膜-中层厚度(IMT)的变化及干预组的不良反应。结果平均随访1.8年后,干预组总的心血管事件再发率较对照组明显降低(P<0.01),其中心血管病因死亡率差异无统计学意义(P>0.05),但次要终点事件(非致命性再梗死、新发的心绞痛、脑卒中、严重心力衰竭)明显减少(P<0.05);干预组颈动脉IMT显著低于对照组(P<0.05);两组间严重胃肠不良反应发生率差异无统计学意义(P>0.05)。结论阿卡波糖可有效延缓老年AMI合并IGT患者的颈动脉IMT增厚,降低再发心血管事件的风险,同时阿卡波糖在老年患者中安全性、耐受性良好。

[ Objective ] To study the effect and safety of Acarbose on elderly patients with acute myocar- dial infarction （AMI） complicating impaired glucose tolerance （IGT）. [Methods] 105 elderly patients with a- cute myocardial infarction complicating IGT were randomly divided into treatment group （n =53） and control group （n =52）. All cases were given the same elementary treatment, cases in treatment group were adminis- tered Aearbose additionally. [Results] During the average follow-up of 1.8 years, the risk of recurrent major cardiovascular event （MACE） and carotid intima-media thickness was decreased significantly compared with that in control group （P〈0.05）. Meanwhile, there was no significant difference in severe gastrointestinal ad- verse reaction between two groups （P〉0.05）. [Conclusion] Acarbose can effectively and securely degrade the risk of MACE in acute myocardial infarction elderly patients complicating IGT, simultaneously retard the progression of carotid intima-media thickeness.