Shaienko Zlatoslava O, Bobyreva Lyudmila Ye
Higher State Educational Establishment Of Ukraine "Ukrainian Medical Stomatological Academy", Poltava, Ukraine.
Wiad Lek. 2018;71(2 pt 2):278-280.
Introduction: The early development and high incidence of cardiovascular lesion in patients with type 2 diabetes mellitus is one of the most serious challenges for the diabetology worldwide. The aim: The purpose of the paper is to determine the dynamics of the insulin resistance indices in patients with type 2 diabetes mellitus concomitant with coronary heart disease in the combination therapy with metformin and pioglitazone during 3 and 6 months.
Materials and methods: 95 patients with type 2 diabetes mellitus and coronary heart disease have been treated and randomized into two groups: the comparison group (n=37), treated with metformin and sulfonylureas, and the study group (n=58), treated with metformin in combination with pioglitazone. Prior, after 3 and 6 months of treatment C-peptide was assessed and index of the insulin resistance was calculated.
Results: The resulting data proved the statistically significant lowering of the markers and level of the insulin resistance under the effect of combination treatment with metformin and pioglitazone.
Conclusions: The proposed variant of the combination therapy has a positive effect on the clinical course of the coronary heart disease in patients with type 2 diabetes mellitus, well tolerated by the patients and can be considered as the pathogenetic factor in the treatment of these diseases.
引言：2型糖尿病患者心血管病变的早期发展及高发病率是全球糖尿病学面临的最严峻挑战之一。目的：本文旨在确定2型糖尿病合并冠心病患者在联合使用二甲双胍和吡格列酮治疗3个月和6个月期间胰岛素抵抗指数的变化情况。
材料与方法：95例2型糖尿病合并冠心病患者接受治疗并随机分为两组：对照组（n = 37），接受二甲双胍和磺脲类药物治疗；研究组（n = 58），接受二甲双胍联合吡格列酮治疗。在治疗前、治疗3个月和6个月后评估C肽水平并计算胰岛素抵抗指数。
结果：所得数据证明，二甲双胍和吡格列酮联合治疗可使胰岛素抵抗标志物和水平在统计学上显著降低。
结论：所提出的联合治疗方案对2型糖尿病合并冠心病患者的冠心病临床病程有积极影响，患者耐受性良好，可被视为治疗这些疾病的致病因素。
