高占群 李霜 刘杨

摘要：目的  分析苯那普利聯合阿托伐他汀治疗冠心病合并2型糖尿病（T2DM）心功能不全患者的临床疗效。方法  选择我院2016年10月～2017年9月收治的70例冠心病合并T2DM心功能不全患者为研究对象，随机分为普通组与观察组，各35例，普通组患者行阿托伐他汀治疗，观察组在此基础上联合苯那普利治疗，比较两组患者空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）水平，左心室射血分数（LVEF）、左心室舒张末内径（LVEDD）及左心室收缩末内径（LVESD），随访1年观察两组不良事件发生情况。结果  观察组患者FBG、2hPG、HbA1c分别为（5.53±1.10）mmol/L、（7.79±1.12）mmol/L、（7.12±0.86）%，低于对照组的（6.87±1.54）mmol/L、（9.12±1.43）mmol/L、（8.04±1.01）%，差异有统计学意义（P<0.05）;观察组LVEF水平高于普通组，LVEDD、LVESD低于普通组，差异有统计学意义（P<0.05）;随访1年，观察组不良事件发生率为8.57%，低于普通组的25.71%，差异有统计学意义（P<0.05）。结论  苯那普利联合阿托伐他汀治疗冠心病合并T2DM心功能不全患者，临床疗效显著，可降低患者血糖水平，改善其心功能，减少不良事件的发生，应用效果较好。

关键词：阿托伐他汀;苯那普利;冠心病;2型糖尿病;心功能不全

Abstract：Objective  To analyze the clinical efficacy of benazepril combined with atorvastatin in patients with coronary heart disease complicated with type 2 diabetes mellitus （T2DM）.Methods  70 patients with coronary heart disease and T2DM cardiac dysfunction who were admitted to our hospital from October 2016 to September 2017 were randomly divided into the general group and the observation group， 35 cases each. The general group received atorvastatin treatment， the observation group was combined with benazepril on the basis of this， comparing fasting blood glucose （FBG）， postprandial 2h blood glucose （2hPG）， glycosylated hemoglobin （HbA1c） level， left ventricular ejection fraction （LVEF）， left Ventricular end diastolic diameter （LVEDD） and left ventricular end-systolic diameter （LVESD） were observed at 1 year follow-up.Results  The FBG， 2hPG and HbA1c in the observation group were （5.53±1.10） mmol/L， （7.79±1.12） mmol/L， （7.12±0.86）%， which was lower than that of the control group （6.87±1.54） mmol/L， （ 9.12±1.43）mmol/L， （8.04±1.01）%， the difference was statistically significant （P<0.05）; the LVEF level in the observation group was higher than that in the normal group， and the LVEDD and LVESD were lower than the normal group， the difference was statistically significant （P<0.05）; After 1 year of follow-up， the incidence of adverse events was 8.57% in the observation group， which was lower than that in the normal group 25.71%，the difference was statistically significant （P<0.05）.Conclusion  Benazepril combined with atorvastatin in the treatment of patients with coronary heart disease and T2DM cardiac dysfunction has a significant clinical effect， which can reduce blood glucose levels， improve cardiac function， reduce adverse events， and have a good application effect.

Key words：Atorvastatin;Benazepril;Coronary heart disease;Type 2 diabetes;Cardiac insufficiency

冠心病（coronary heart disease）是临床中常见的心血管疾病，多发生于中老年人群体，尤其是近年来随着人口老龄化趋势的加剧，冠心病发病率不断增长。2型糖尿病（T2DM）是一种内分泌代谢性疾病，可累及全身各个器官[1]，对患者日常生活与身体健康都造成了严重影响。研究发现，心血管疾病是导致T2DM患者死亡的主要因素，冠心病与T2DM合并会相互推进病情发展，患者病情复杂，治疗难度增大，临床需在控制血糖的基础上加强冠心病的治疗干预。目前针对这一病症多采用药物治疗，阿托伐他汀可有效改善患者血脂水平，而苯那普利则能减少患者胰岛素抵抗[2]。因而，本研究采用阿托伐他汀联合苯那普利治疗我院收治的冠心病合并T2DM心功能不全患者，旨在观察其临床疗效及安全性，现报告如下。

1资料与方法