吡格列酮干预对代谢综合征患者颈动脉重构的影响  

Effect of pioglitazone on arteria carotis remodeling in patients with metabolic syndrome

作　　者：罗玉梅[1,2] 姜文玲[3] 许丹焰[1] 姜德谦[1] 

机构地区：[1]中南大学湘雅二医院心内科,长沙410011 [2]深圳市龙岗区人民医院心内科,深圳518172 [3]中南大学湘雅二医院肾脏病研究所,长沙410011

出　　处：《中南大学学报（医学版）》2013年第7期681-685,共5页Journal of Central South University ：Medical Science

摘　　要：目的:通过观察吡格列酮干预对代谢综合征患者颈动脉内中膜厚度、斑块阳性率的影响,为改善代谢综合征患者动脉重构寻找新的方法。方法:将代谢综合征患者分为对照组(n=60)和吡格列酮组(n=61),所有患者均给予降压、降胆固醇、降糖等基础治疗,吡格列酮组加用吡格列酮(15 mg/d),对照组加用安慰剂(维生素C)干预24周。采用彩色多普勒超声测量2组患者干预后颈动脉内中膜厚度及斑块阳性率,用日本日立7600-020自动生化分析仪测定空腹血清三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、游离脂肪酸、空腹血糖、餐后2小时血糖及肝肾功能等生化指标;分析比较干预后吡格列酮组和对照组患者颈动脉内中膜厚度、斑块阳性率及各血生化指标的差异。结果:干预后,与对照组比较,吡格列酮组患者颈动脉斑块阳性率较对照组明显降低(P<0.05),颈动脉内中膜厚度无明显差异(P>0.05),血清三酰甘油、游离脂肪酸水平降低(P<0.05),其他生化指标无明显差异(P>0.05)。结论:吡格列酮干预可改善代谢综合征组患者颈动脉重构,较基础治疗更显著地抑制其斑块形成。Objective： To observe the effect ofpioglitazone on carotid artery intima-media thickness （IMT） and plaque-positive rate in patients with metabolic syndrome, and to find a new way to improve arterial remodeling in patients with metabolic syndrome. Methods： Patients with metabolic syndrome were randomly divided into a control group （n=60） and a pioglitazone group （n=61）. M1 subjects received basic therapeutic measures, i.e, appropriate medication to control blood pressure, blood sugar and cholesterol. Pioglitazone （15 mg/d） was given to patients in the pioglitazone group, and placebo （vitamin C） in the control group for 24 weeks. Color doppler ultrasound was used to measure carotid artery IMT and plaque-positive rateof patients in the 2 groups after the intervention. Japan＇s Hitachi 7600-020 automatic biochemical analyzer was used to measure fasting serumal triglycerides, total cholesterol, high density lipoprotein cholesterol, low-density lipoprotein cholesterol, free fatty acids, fasting blood glucose, 2-hour postprandial glucose and liver and kidney function, etc. The differences between groups after the intervention were analyzed and compared in IMT, plaque-positive rate and all blood biochemical indicators. Results： After the intervention, compared with the control group, carotid artery plaque-positive rate and the levels of triglyceride and free fatty acid decreased in the pioglitazone group （P〈0.05）, but there was no difference in IMT of carotid artery and other blood biochemical indicators between the 2 groups （P〉0.05）. Conclusion： Pioglitazone intervention can significantly improve pathologic artery remodeling, and it can more effectively inhibit the arterial plaque-formation than basic therapeutic measures in patients with metabolic syndrome.

关 键 词：代谢综合征 心血管重构 过氧化物酶体增殖物激活受体-Γ 

分 类 号：R589[医药卫生—内分泌]