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将64例2型糖尿病合并冠心病PCI术后患者随机分为A、B两组,两组均采用抗血小板聚集、降脂、扩冠治疗,A组:赖脯胰岛素25+吡格列酮降糖(剂量个体化);B组:二甲双胍+格列吡嗪降糖(剂量个体化)。治疗24周,观察治疗前后两组BMI、收缩压、舒张压、空腹血糖、餐后2小时血糖、糖化血红蛋白、血浆纤维蛋白原、甘油三酯、低密度脂蛋白变化,并在治疗的24周对有至少1次胸闷、胸痛发作的12例患者复查冠脉造影。治疗前后两组的差值在BMI、胆固醇方面无明显差异,但在血糖、甘油三酯、血压方面却有显著性差异。A组3例出现支架内再狭窄,B组6例出现支架内再狭窄。在PCI术后的2型糖尿病患者中采用赖脯胰岛素25+吡格列酮降糖治疗,能有效减少再狭窄的发生。
Sixty-four patients with type 2 diabetes mellitus with coronary heart disease undergoing PCI were randomly divided into A and B groups. Antiplatelet aggregation, lipid-lowering and crown-expanding were used in both groups. Group A: insulin lispro 25 + hypoglycemic Individualized); Group B: metformin + glipizide hypoglycemic (dose individualized). After 24 weeks of treatment, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, plasma fibrinogen, triglyceride and low density lipoprotein were observed before and after treatment. Coronary angiography was performed on 12 patients who had at least one episode of chest tightness and chest pain. Before and after treatment, the difference between the two groups in the BMI, cholesterol no significant difference, but in blood glucose, triglycerides, blood pressure there are significant differences. Stent restenosis occurred in 3 cases in group A, and in-stent restenosis in group B in 6 cases. In patients with type 2 diabetes after PCI using lispro 25 + pioglitazone hypoglycemic treatment, can effectively reduce the incidence of restenosis.