氯吡格雷联合二甲双胍对2型糖尿病伴冠状动脉粥样硬化性心脏病肥胖患者治疗效果的影响研究  

Study on the Effect of Clopidogrel Combined with Metformin on the Treatment of Obese Patients with Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease

作　　者：陈孝芹 叶奎 CHEN Xiaoqin;YE Kui(Department of Cardiology,Longnan First People's Hospital,Longnan 746000,Gansu,China)

机构地区：[1]陇南市第一人民医院心血管内科,甘肃陇南746000

出　　处：《糖尿病新世界》2025年第5期77-80,共4页Diabetes New World

摘　　要：目的探讨氯吡格雷结合二甲双胍改善2型糖尿病伴冠状动脉粥样硬化性心脏病(简称冠心病)肥胖的价值。方法纳入2023年1月—2024年6月陇南市第一人民医院接诊的100例2型糖尿病伴冠心病肥胖患者,根据治疗方法的不同进行组别划分,对照组(50例)给予氯吡格雷联合达格列净治疗,观察组(50例)给予氯吡格雷联合二甲双胍治疗。比较两组临床疗效、血糖指标、心功能指标、体重指数及胰岛功能。结果干预后,相较于对照组,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、体重指数、胰岛素抵抗指数水平均更低,胰岛β细胞功能指数、治疗总有效率均更高,差异均有统计学意义(P均<0.05)。干预后,两组左室舒张末期内径、舒张末期室间隔厚度比干预前更低,左室射血分数比干预前更高,差异均有统计学意义(P均<0.05)。但组间心功能指标对比,差异均无统计学意义(P均>0.05)。结论利用氯吡格雷结合二甲双胍改善2型糖尿病伴冠心病肥胖,便于调节血糖指标,治疗有效性更高,且有助于体重调节。Objective To investigate the value of clopidogrel combined with metformin in improving obesity in type 2 diabetes mellitus complicated with coronary heart disease.Methods A total of 100 obese patients with type 2 diabetes mellitus complicated with coronary heart disease who were admitted to the Longnan First People's Hospital from January 2023 to June 2024 were divided into groups according to different treatment methods.The control group(50 cases)was treated with clopidogrel combined with dapagliflozin,and the observation group(50 cases)was treated with clopidogrel combined with metformin.The clinical efficacy,blood glucose indexes,cardiac function indexes,body mass index and islet function of the two groups were compared.Results After intervention,compared with the control group,the levels of fasting plasma glucose,2-hour postprandial plasma glucose,glycated hemoglobin A1c,body mass index and homeostatic model assessment of insulin resistance in the observation group were lower,the homeostatic model assessment ofβ-cell function level and the total effective rate of treatment were higher,the differences were statistically significant(all P<0.05).After intervention,the left ventricular end-diastolic diameter and end-diastolic interventricular septal thickness of the two groups were lower than those before intervention,and the left ventricular ejection fraction was higher than that before intervention,the differences were statistically significant(all P<0.05).However,there were no significant difference in cardiac function between the two groups(all P>0.05).Conclusion Clopidogrel combined with metformin is used to improve obesity in type 2 diabetes mellitus complicated with coronary heart disease,which is convenient to regulate blood glucose indicators,has higher treatment effectiveness,and helps weight regulation.

关 键 词：氯吡格雷 二甲双胍 2型糖尿病 冠状动脉粥样硬化性心脏病肥胖 治疗效果 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]