目的 观察吡格列酮和阿托伐他汀联合应用对冠心痛合并2型糖尿病PCI术后患者抗炎症作用的影响.方法 选择冠心痛合并2型糖尿病行PCI的患者116例,随机分为观察组56例,接受吡格列酮15 mg/d和常规治疗;对照组60例仅接受常规治疗.术后随访12周.分别于治疗前、治疗4、12周后检测血脂、高敏C反应蛋白(hs-CRP)、TNF-α、基质金属蛋白酶9(MMP-9)及颈动脉内膜中层厚度(IMT)变化.结果 2组患者治疗后4、12周hs-CRP、MMP-9、TNF-α明显下降(P＜0.05,P＜0.01);与对照组比较,观察组治疗后12周hs-CRP、MMP-9、TNF-α明显下降(P＜0.05);与治疗前比较,2组患者治疗后4周(除TG外)、12周TC、LDL-C明显下降(P＜0.05,P＜0.01).2组患者治疗后12周时HDL-C明显升高,TG明显下降(P＜0.01).结论 冠心病合并2型糖尿病患者吡格列酮和阿托伐他汀联合应用能有效降低炎性因子水平.%Objective To observe the antiinflammatory effect of pioglitazone combined with atorvastatin in the patients with coronary heart disease complicated with type-2 diabetes after PCI. Metheds 116 patients with coronary heart disease complicated with type-2 diabetes after PCI were randomly divided into two groups:Observation group(56 patients) accepted pioglitazone 15 mg/d and routine therapy; the control group only accepted conventional treatment. Both groups were followed up for 12 weeks. Blood lipid,serum hs-CRP,TNF alpha,serum MMP-9 and carotid IMT changes were measured before,and 4 weeks, 12 weeks after the treatment. Results Serum MMP-9, hs-CRP, TNF-a in both groups dropped significantly after treatment for 4 and 12 weeks (P＜0. 05) ,but the decrease was more obvious in observation group than in controls group (P＜ 0. 01). Conclusion Pioglitazone combined with atorvastatin can effectively reduce the inflammatory factor levels, inhibit atherosclerosis progress in patients with coronary heart disease and type-2 diabetes.
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