【摘要】 目的观察二甲双胍干预非糖尿病患者胰岛素抵抗(insulin resestence,IR)对冠状动脉支架植入术(percutaneous coronary intervention,PCI)后急性心血管事件以及冠脉支架再狭窄的影响。方法对97例冠状动脉病变接受PCI术并发IR的非糖尿病患者随机分成2组,一组在基础治疗的基础上加用二甲双胍片(0.5g,3次/d,口服)作为试药组,另一组仅作基础治疗为对照组,观察两组支架植入术后一年的急性心血管事件(心绞痛、心肌梗死、心因性死亡)及支架内再狭窄的发生率。结果术后1年11例失访。86例随访中,试药组(n=41)5例发生心绞痛,无心肌梗死发生,造影复查47处植入支架发现再狭窄6例,即再狭窄发生率为13%(6/47);对照组(n=45)14例发生心绞痛,2例发生心肌梗死(ST段抬高、非ST段抬高各1例),造影复查53例植入支架发现再狭窄10例,另有2例出现新的冠脉狭窄(病变的狭窄程度≥50%),即再狭窄发生率为30%(16/53)。急性心血管事件和支架内再狭窄发生率试药组低于对照组(均P<0.05)。结论在非糖尿病患者伴IR行PCI术后应用二甲双胍进行干预可以降低患者的急性心血管事件以及冠脉支架再狭窄发生率。更多还原

【Abstract】 AIM To investigate the effects of metformin on acute cardiovascular events and restenosis after percutaneous coronary intervention(PCI)in nondibetic patients with insulin resistance(IR).METHODS Ninety-seven nondiabetic patients with IR after successful PCI were enrolled and randomized into two groups:treatment group and control group.The patients in the treatment group orally took metformin 0.5g three times a day besides the basal therapy after PCI,while the control group only received routine treatment.Follow-up coronary angiography(CAG)was performed about 1 year after PCI and acute cardiovascular events(angina pectoris,myocardial infarction,cardiac death)and restenosis after PCI were carefully observed in about 1 year.RESULTS Of the 97 patients,86 completed the regimen.In the treatment group(n=41),angina pectoris was found in 5 cases without myocardial infarction and follow-up CAG showed 6 lesions of restenosis in 47 original lesions.In the control group(n=45),angina pectoris was found in 14 cases of and myocardial infarction in 2 cases and follow-up CAG showed 10 lesions of restenosis as well as 2 new stenosis in 53 original lesions.After the oral metformin intervention there was a decrease in the incidence of acute cardiovascular events and restenosis after PCI(all P<0.05).CONCLUSION Metformin decreases acute cardiovascular events and restenosis after PCI in nondiabetic patients with IR.更多还原