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目的观察罗格列酮对冠心病合并2型糖尿病患者血糖、血脂、超敏C-反应蛋白(hs-CRP)、组织型纤溶酶原激活物(t-PA)及纤溶酶原激活物抑制剂-1(PAI-1)水平的影响。方法将50例患者随机分为治疗组(n=24)和对照组(n=26),对照组给予常规治疗,治疗组在常规治疗的基础上加用罗格列酮4 mg/d,于治疗前及治疗12周时检测空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白A1c(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP、t-PA和PAI-1的含量。结果经过12周的治疗,在血糖方面,两组FPG、2hPG、HbA1c均较治疗前明显下降,差异有统计学意义(P<0.05或P<0.01),且治疗组各指标均小于对照组,差异有统计学意义(P<0.05);在血脂方面,两组TC、LDL-C均较治疗前明显下降,差异有统计学意义(P<0.05),而除此之外,HDL-C显著上升,差异有统计学意义(P<0.05);在抗炎方面,两组hs-CRP均较治疗前明显下降,差异有统计学意义(P<0.05或P<0.01),且治疗组各指标均小于对照组,差异有统计学意义(P<0.05);在对纤溶系统的影响方面,治疗组t-PA明显上升、PAI-1显著下降,差异有统计学意义(P<0.05)。结论对于冠心病合并2型糖尿病患者,在常规治疗的基础上加用罗格列酮可更好地控制血糖,调节血脂和抗炎并改善体内血栓前状态。
Objective To observe the effects of rosiglitazone on blood glucose, blood lipids, hs-CRP, t-PA and plasminogen activator in patients with coronary heart disease complicated with type 2 diabetes mellitus Inhibitor-1 (PAI-1) levels. Methods Fifty patients were randomly divided into treatment group (n = 24) and control group (n = 26). The control group was given routine treatment. The treatment group was treated with rosiglitazone 4 mg / d Fasting blood glucose (FPG), postprandial 2h glucose (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol -C), high density lipoprotein cholesterol (HDL-C), hs-CRP, t-PA and PAI-1. Results After 12 weeks of treatment, the FPG, 2hPG and HbA1c levels in both groups were significantly lower than those before treatment (P <0.05 or P <0.01), and the indexes in the treatment group were all less than those in the control group. The difference was statistically significant (P <0.05); in the blood lipid, TC and LDL-C in both groups were significantly lower than before treatment, the difference was statistically significant (P <0.05), but otherwise, HDL-C was significant (P <0.05). In terms of anti-inflammatory, hs-CRP in both groups was significantly lower than that before treatment, the difference was statistically significant (P <0.05 or P <0.01), and the treatment group indicators (P <0.05). Compared with the control group, t-PA significantly increased and PAI-1 decreased significantly (P <0.05) in fibrinolytic system. Conclusions For patients with type 2 diabetes and coronary heart disease, adding rosiglitazone to conventional therapy can better control blood sugar, regulate blood fat and anti-inflammation, and improve the prethrombotic state in vivo.