PCI术后短期内应用强化他汀治疗对糖耐量异常患者血糖影响的临床研究

The clinical research of effects of short term intensive statin therapy on glucose in patients with impaired glucose tolerance after percutaneous coronary intervention

目的短期内应用强化他汀类药物对接受经皮冠状动脉介入治疗（PCI）合并糖耐量异常（IGT）患者术后血糖影响的临床研究。方法选取2013年2月至2014年11月在连云港市第二人民医院接受PCI治疗的IGT患者126例，将其随机分成强化组和常规组，各63例。强化组患者在PCI术前给予20mg瑞舒伐他汀顿服，术后以每晚20mg口服1个月，之后改为每晚10mg口服治疗；常规组患者在PCI术前后一直予以10mg瑞舒伐他汀口服治疗。两组患者住院期间均规范化给予阿司匹林、氯吡格雷、β受体阻滞剂、扩血管等药物常规治疗，在PCI围手术期均予以低分子量肝素抗凝治疗，随访并记录患者在术后1个月及3个月的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）水平和新发糖尿病例数。结果两组与治疗前相比较，血脂指标TC、LDL—C（1、3个月）降低，血糖指标2hPG（1、3个月）升高，新发糖尿病例数（1、3个月）增加，而FPG、HbA1c（1、3个月）无显著变化，其中强化组治疗1个月后与常规组同期相比较，TC、LDL—C降低幅度更明显，2hPG、新发糖尿病例数升高幅度更明显，且差异均有统计学意义（均P〈0．05）；而在治疗3个月后两组相比较，上述指标差异无明显统计学意义（P〉0．05）。结论PCI术后短期内应用强化他汀治疗可使糖耐量异常患者易发生他汀类药物相关的糖尿病，且具有剂量依赖性。

Objective To observe the effects of short term intensive statin on glucose in patients with percutaneous coronary intervention （PCI） surgery combining impaired glucose tolerance （IGT）. Methods From February 2013 to November 2014,a total of 126 patients with PC/combining IGT treated in the Second People＇s Hospital of Lianyungang were studied.These patients were randomly divided into intensive group and regular Group.Intensive group（63 cases） were given 20 rng rosuvastatin before PCI surgery,and 20 mg rosuvastatin every night for one month after PCI surgery.Patients in regular Group（63 cases） were given 10 mg rosuvastatin every night during treatment.2 groups of patients were normalized to conventional treatment such as aspirin, clopidogrel, beta blockers, vascular drugs and so on,in the PCI perioperative are given low molecular weight heparin for anticoagulant therapy.observe and pay a return visit to the total cholesterol （TC）,low-density lipoprotein cholesterol （LDL-C）,fasting plasma glucose （FPG）,2-hour postprandial glucose （2 hPG）,glycosylated hemoglobin （HbA1c） levels and the number of new-onest of diabetes after 1 and 3 months. Results After treatment,the TC and LDL-C levels （1,3 months） were decreased ,2 hPG levels and the number of new-onest of diabetes （1,3 months） were increased in both groups,but there were no significant changes in the indexs of FPG and HbA1c levels （1,3 months）.the decrease of TC,LDL-C levels and the increase of 2hPG level and the number of new-onest of diabetes in intensive group was more significance than that in regular Group after 1 month＇s treatment,which had a significantly difference in the statistical studies （P〈0.05）. However,there was no statistical significance between intensive group and regular Group in these indexs after 3 months＇ treatment （P〉0.05）. Conclusions Short term intensive statin therapy can increase the risk of diabetes related to drugs in the patients with IGT after PCI surgery,which increases with a dose-dependent manner.