【摘要】 目的 比较并评估不同降糖药对冠心病合并糖尿病患者重复血运重建的影响。方法 筛选了952名在2015年至2021年间于西安交通大学第一附属医院接受经皮冠状动脉介入(PCI)治疗的冠心病合并糖尿病患者，统计重复PCI的发生率，分析4类降糖药物(胰岛素、磺酰脲、二甲双胍和α-葡萄糖苷酶抑制剂)对重复PCI的影响。并根据体重指数进行亚组分析。结果 重复PCI手术患者的男性比例高于未重复手术治疗的患者。重复PCI治疗者的胰岛素治疗率更高，BMI更高，差异有统计学意义(P <0.05)。未重复PCI患者的血糖和血脂水平均低于重复PCI者。二甲双胍显著降低了研究人群重复PCI治疗的风险。在肥胖个体中，本研究没有观察到口服降糖药的数量与重复PCI风险之间的显著相关性。结论 在接受PCI治疗的糖尿病患者中，二甲双胍治疗与重复血运重建的风险降低有关，应选择适当的降糖药物进行冠心病的二级预防。更多还原

【Abstract】 Objective To compare and evaluate the effects of different glucose lowering agents on repeat revascularization in CAD patients with diabetes. Methods In 952 patients undergoing percutaneous coronary artery intervention(PCI) at the First Affiliated Hospital of Xi’an Jiaotong University between 2015 and 2021, the incidence of repeated PCI was analyzed, and the effects of four glucose lowering agents(insulin, sulfonylurea, metformin and α-glucosidase inhibitors) on repeated PCI was analyzed. And a subgroup analysis was performed according to the body mass index. Results The proportion of men was higher in patients who underwent repeat revascularization with PCI than in those who did not. Repeat PCI patients had higher insulin treatment rates and higher BMI(P < 0.05). Both blood glucose and lipid levels were lower in patients without repeat PCI than in those with repeat PCI. Metformin significantly reduced the risk of repeated PCI treatment in the study population. In obese individuals, a significant association between the number of oral antidiabetic agents and the risk of repeated PCI was not observed in this study. Conclusion In diabetic patients receiving PCI, metformin treatment is associated with a reduced risk of repeat revascularization, and appropriate hypoglycemic drugs should be selected for secondary prevention of CHD.更多还原