瑞舒伐他汀联合二甲双胍对冠状动脉支架内再狭窄及血糖的影响

Effects of rosuvastatin combined with metformin on coronary stent restenosis and blood glucose

目的探讨冠心病患者行冠状动脉介入术后采用瑞舒伐他汀钙联合二甲双胍治疗降低冠状动脉支架内再狭窄发生率的效果及对血糖的影响。方法 218例冠心病支架术后患者,依据随机数字表法分为观察组（109例）和对照组（109例）。对照组患者给予瑞舒伐他汀钙20 mg加常规治疗,观察组患者在常规治疗基础上给予瑞舒伐他汀钙20 mg联合二甲双胍250 mg,一日2次,比较两组1年后冠状动脉支架内再狭窄率及血糖异常发生率。结果观察组与对照组患者冠状动脉支架内再狭窄发生率分别为2.9%（3/103）和12.0%（12/100）,新发糖尿病比率为5.8%（6/103）和15.0%（15/100）,新发糖耐量减低分别为4.9%（5/103）与18.0%（18/100）,差异均有统计学意义（P〈0.05）。观察组血脂达标率（56.0%）明显高于对照组（43.0%）,尤其是对甘油三酯的影响,与对照组相比差异有显著性（P〈0.01）。结论冠心病患者行冠状动脉介入术后采用瑞舒伐他汀钙联合二甲双胍治疗能够显著降低冠状动脉支架内再狭窄发生率,且并不增加糖尿病发病率、低血糖症状发生率,对肾功能影响与对照组无显著差异。

Aim To investigate the effect of rosuvastatin calcium combined with metformin on coronary artery stent restenosis after coronary intervention in patients with coronary heart disease（ CHD）. Methods 218 patients with coronary artery disease after stenting were divided into observation group（ 109 cases） and control group（ 109 cases） according to the random number table method. The control group were treated with rosuvastatin calcium 20 mg and routine treatment,the observation group was treated with rosuvastatin calcium（ 20 mg） combined with metformin（ 250 mg,Bid） on the basis of conventional treatment,after 1 year of treatment,coronary stent restenosis rate and the incidence of abnormal blood glucose were compared between the two groups. Results Coronary artery stent restenosis rate was 2.9%（ 3/103） and 12. 0%（ 12/100）,new onset diabetes ratio was 5.8%（ 6/103） and 15.0%（ 15/100）,new onset diabetes impaired were 4.9%（ 5/103） and 18.0%（ 18/100） in patients of observation group and control group,the difference was statistically significant（ P〈0.05）. The blood lipid compliance rate of the observation group was significantly higher than that of the control group（ 56. 0% vs 43. 0%）,especially TG,the difference was statistically significant compared with the control group（ P〈0.01）.Conclusion In patients with coronary heart disease after percutaneous coronary intervention,rosuvastatin combined with metformin can significantly reduce coronary artery stent restenosis rate,and does not increase the incidence of diabetes,hypoglycemia incidence. There was no significant difference in the effect on renal function compared with control group.