吡格列酮联合通心络胶囊对2型糖尿病合并冠心病行PCI置入DES患者术后评估

Postoperative Evaluation of Pioglitazone Combined with Tongxinluo Capsules in Patients with Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease Undergoing Percutaneous Coronary Intervention with Drug-eluting Stents

目的:探讨吡格列酮联合通心络胶囊对2型糖尿病(T2DM)伴冠心病行经皮冠状动脉介入治疗(PC)I患者置入药物洗脱支架(DES)支架内再狭窄(ISR)和主要不良心血管事件(MACE)发生的影响。方法:将114例T2DM伴冠心病并行PCI患者作为研究对象,随机分为2组各57例,对照组给予安慰剂胶囊及吡格列酮,联合组给予吡格列酮及通心络胶囊。均治疗1年。术后2组患者均随访1年,比较2组患者ISR发生率、晚期管腔丢失(支架阶段内管腔直径分析)、直径狭窄率及MACE的发生情况。结果:2组术前血脂血糖指标比较,差异无统计学意义(P> 0.05)。术前术后血脂、血糖指标比较,差异无统计学意义(P> 0.05)。随访1年,2组均获随访,联合组ISR发生率及直径狭窄率较对照组均下降(P <0.05),晚期管腔丢失较对照组减少(P <0.05)。联合组MACE发生率5.26%,较对照组19.30%低(P <0.05)。结论:对行PCI置入雷帕霉素DES的T2DM伴冠心病患者给予吡格列酮联合通心络胶囊治疗可有效降低ISR及MACE的发生率,安全、可靠。

Objective:To discuss the effect of pioglitazone combined with Tongxinluo capsules on in-stent restenosis(ISR)and major adverse cardiovascular events(MACE)in patients with type 2 diabetes mellitus(T2 DM)complicated with coronary heart disease undergoing percutaneous coronary intervention(PCI)with drug-eluting stents(DES).Methods:A total of 114 cases of patients with T2 DM complicated with coronary heart disease were selected as the study subjects and were divided into two groups,57 cases in each group.The control group was treated with placebo capsules and pioglitazone,and the combination group was treated with pioglitazone and Tongxinluo capsules.Both groups were treated for one year.Patients after operation in the two groups were followed up for one year,and the incidence of ISR,late luminal loss(luminal diameter analysis at stent stage),diameter stenosis rate and MACE in the two groups were compared.Results:There was no significant difference being found in the comparison of indexes of blood lipid and blood glucose before operation in the two groups(P>0.05).There was no significant difference being found in the comparison of indexes of blood lipid and blood glucose before and after operation(P>0.05).After one-year follow-up in the two groups,the incidence of ISR and diameter stenosis rate in the combination group were decreased when compared with those in the control group(P<0.05),and the late luminal loss in the combination group was reduced when compared with that in the control group(P<0.05).The incidence of MACE was 5.26%in the combination group,lower than that of 19.30%in the control group(P<0.05).Conclusion:The therapy of pioglitazone combined with Tongxinluo capsules for patients with T2 DM complicated with coronary heart disease undergoing PCI with DES of rapamycin can effectively reduce the incidence of ISR and MACE,which is safe and reliable.