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目的探讨胰岛素增敏剂罗格列酮(RGZ)干预支架内再狭窄(RS)的作用机制。方法选取2009年3～12月我科收治的合并T2DM的冠心病(CHD)患者72例,均择期行选择性冠状动脉造影,必要时行支架安置术。术后随机分为RGZ干预组和Con组。术前和术后第1、3、6个月复查进行常规生化检测,ELISA测定血浆APN、内皮素(ET)含量,统计学分析并记录患者RS事件的发生情况。结果术后3个月,RGZ干预组较Con组血浆APN含量明显升高,血清Ins含量有所下降(P均<0.05);术后6个月,RGZ干预组较Con组血浆ET含量明显降低,FPG水平明显降低(P均<0.05)。结论 RGZ可通过升高血浆APN、降低血浆ET含量,对合并T2DM的CHD患者术后RS起到一定的预防作用,其作用随着术后用药时间的延长逐渐显现。
Objective To investigate the mechanism of insulin sensitizer rosiglitazone (RGZ) on in-stent restenosis (RS). Methods Seventy-two patients with coronary heart disease (CHD) with T2DM admitted from March to December 2009 in our department were enrolled in this study. All patients underwent elective coronary angiography and stent placement was performed if necessary. The patients were randomly divided into RGZ intervention group and Con group. Preoperative and postoperative 1,3,6 months review for routine biochemical tests, plasma APN, ELISA determination of plasma endothelin (ET) levels, statistical analysis and record of patients with RS events. Results At 3 months after operation, the plasma APN level in RGZ intervention group was significantly higher than that in Con group, while the serum Ins level was decreased (all P <0.05). At 6 months after operation, the plasma ET level in RGZ intervention group was significantly lower than that in Con group , FPG levels decreased significantly (all P <0.05). Conclusions RGZ can prevent RS of postoperative RS in CHD patients with T2DM by increasing plasma APN and decreasing plasma ET level. The effect of RGZ gradually appears with the extension of time after operation.