强化降糖配合罗格列酮对老年冠心病合并2型糖尿病病人血脂和载脂蛋白的影响

Effect of intensive glucose lowering combined with rosiglitazone on the levels of blood lipid and apolipoprotein in senile CHD patients complicated with type 2 diabetes

目的:探讨强化降糖配合罗格列酮对老年冠心病合并2型糖尿病病人血脂和载脂蛋白的影响。方法:将72例老年冠心病合并2型糖尿病病人随机分为2组,对照组36例给予强化降糖治疗,观察组36例给予强化降糖配合罗格列酮治疗,2组均持续治疗3个月,并随访12个月以上。比较2组治疗后临床疗效,检测2组治疗前后血脂和载脂蛋白水平,统计随访期间心血管不良事件发生情况。结果:治疗后,观察组治疗总有效率88.89%,高于对照组的69.44%(P<0.05);2组总胆固醇、三酰甘油、低密度脂蛋白胆固醇和载脂蛋白B均有降低(P<0.05～P<0.01),高密度脂蛋白胆固醇和载脂蛋白A1均有升高(P<0.05～P<0.01),且观察组总胆固醇、三酰甘油、低密度脂蛋白胆固醇和载脂蛋白B水平的下降幅度、高密度脂蛋白胆固醇和载脂蛋白A1的升高幅度均大于对照组(P<0.05～P<0.01)。随访期间,观察组病人不良事件发生率22.22%,低于对照组的44.44%(P<0.05)。结论:强化降糖配合罗格列酮治疗老年冠心病合并2型糖尿病,可明显改善血脂和载脂蛋白水平,减少不良事件发生,疗效显著。

Objective： To investigate the effects of intensive glucose lowering combined with rosiglitazone on the levels of blood lipid and apolipoprotein in senile coronary heart disease（ CHD） patients complicated with type 2 diabetes. Methods： Seventy-two senile CHD patients complicated with type 2 diabetes were randomly divided into the control group and observation group（ 36 cases each group）.The control group and observation group were treated with intensive glucose lowering and intensive glucose lowering combined with rosiglitazone for 3 months,respectively. Two groups were followed up for 12 months. The clinical curative effect between two groups was compared,the blood lipid and apolipoprotein levels before and after treatment in two groups were detected,and the cardiovascular adverse events in two groups were observed during the following-up period. Results： After the treatment,the total effective rate in observation group（ 88. 89%） was higher than that in control group（ 69. 44%）（ P〈0. 05）,the levels of total cholesterol（ TC）,triacylglycerol（ TG）,low density lipoprotein cholesterol（ LDL-C） and apolipoprotein B（ Apo B） in two groups decreased（ P〈0. 05 to P〈0. 01）,the levels of high density lipoprotein cholesterol（ HDL-C） and apolipoprotein A1（ Apo A1） in two groups increased（ P〈0. 05 to P〈0. 01）,and the decreasing degrees of the levels of TC,TG,LDL-C and Apo B,and increasing degrees of the levels of HDLC and Apo A1 in observation group were higher than those in control group（ P〈0. 05 to P〈0. 01）. During the following-up,the incidence rate of adverse event in observation group（ 22. 22%） was lower than that in control group（ 44. 44%）（ P〈0. 05）.Conclusions： The intensive glucose lowering combined with rosiglitazone in the treatment of the senile CHD patients complicated with type 2 diabetes can significantly improve the levels of blood lipid and apolipoprotein,decrease the adverse event,and the effect of which is significant.