伏格列波糖对合并糖耐量减低老年冠心病患者早期干预治疗的临床研究

Clinical study of early intervention of voglibose on elderly patients with coronary heart disease and impaired glucose tolerance

目的评价伏格列波糖在合并糖耐量减低老年冠心病患者中的早期干预治疗效果。方法 80例合并糖耐量减低老年冠心病患者分为对照组和试验组,各40例,对照组用阿卡波糖50 mg,每天3次,试验组口服伏格列波糖20 mg,每天3次,连续12个月。比较2组疗效及空腹血糖(FPG)、2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、胰岛素β细胞功能(HOMA-β)以及胰岛素抵抗指数(HOMA-IR)指标。结果试验组治疗后FPG、2 h PG、Hb A1c、HOMA-β、HOMA-IR指标显著低于对照组(P<0.05)。试验组合并糖耐量降低发展为2型糖尿病发生率低于对照组;试验组转化为糖耐量正常百分比高于对照组,但差异均无统计学意义(P>0.05)。试验组不良反应发生率为10.0%,显著低于对照组的22.5%(P<0.05)。结论伏格列波糖对老年冠心病合并耐糖量减低患者早期干预疗效好,能够降低患者血糖,降低心血管疾病发生率。

Objective To investigate the effect of early intervention of on elderly patients with coronary heart disease and impaired glucose tolerance. Methods A total of 80 elderly patients with glucose tolerance impairation and coronary heart disease were divided into control group （ n = 40） and trial group （ n = 40 ）. Control group was treated with acarbose, 50 mg, tid; the trial group was treated with voglibose, 20 rag, tid. The treatment lasted for 12 months. The efficacy and fasting blood glucose （FPG）, 2 h glucose （2 h PG ）, glycosylated hemoglobin （ HbA1 c）, insulin resistance index （ HOMA - β ） and insulin resistance index （HOMA -IR） were compared between the two groups. Results The FPG, 2 h PG, HbAlc, HOMA - β and HOMA - IR in the trial group were significantly lower than those in the control group （P 〈 0. 05 ）, and the development of impaired glucose tolerance（IGT） in the trial group was lower than that in the control group, trial group was significantly higher than that in the control group. The rate of normal glu- cose tolerance in trial group was higher than that of control group, but the difference was not statistically significant （P 〉 0.05 ）. The incidence of adverse drug reactions in the trial group was 10. 0% , which was signifi- cantly lower than that in the control group （22. 5%, P 〈 0.05 ）. Conclusion In elderly patients with coronary heart disease combined with reduced glucose resistance, the early intervention treatment effect using voglibose is ideal and the blood glucose and the incidence of cardiovascular disease of patients can be reduced.