CAJ | 학술논문

目的：探讨二甲双胍对急性心肌梗死（AMI）患者心功能的改善情况以及相关的机制。方法采用单中心、随机、安慰剂对照、单盲法，将入选的128例 AMI 患者随机分为对照组（安慰剂）和干预组（二甲双胍，500 mg／bid 口服），同时给予冠状动脉粥样硬化性心脏病（冠心病）二级预防治疗。评估两组患者基线资料和随访3个月后心功能指标。结果两组患者基线资料无明显差别；就诊时已超过溶栓治疗时间窗；两组患者心功能指标 LVEF 和左心室短轴缩短率（FS）和6分钟步行试验（6MWT）值均为正常下限，差异无统计学意义（P ＞0.05）。随访3个月后，与对照组相比，干预组患者血浆 NT-ProBNP 水平较低，而脂联素水平较高，差异有统计学意义（P ＜0.05）；同时干预组心功能指标如 LVEF 和 FS 也优于对照组（P ＜0.05）；虽然干预组患者6MWT 稍高于对照组，但差异无统计学意义（P ＞0.05）。结论二甲双胍对 AMI 未合并糖尿病、且未行血管重建的患者具有心血管保护作用。
목적：탐토이갑쌍고대급성심기경사（AMI）환자심공능적개선정황이급상관적궤제。방법채용단중심、수궤、안위제대조、단맹법，장입선적128례 AMI 환자수궤분위대조조（안위제）화간예조（이갑쌍고，500 mg／bid 구복），동시급여관상동맥죽양경화성심장병（관심병）이급예방치료。평고량조환자기선자료화수방3개월후심공능지표。결과량조환자기선자료무명현차별；취진시이초과용전치료시간창；량조환자심공능지표 LVEF 화좌심실단축축단솔（FS）화6분종보행시험（6MWT）치균위정상하한，차이무통계학의의（P ＞0.05）。수방3개월후，여대조조상비，간예조환자혈장 NT-ProBNP 수평교저，이지련소수평교고，차이유통계학의의（P ＜0.05）；동시간예조심공능지표여 LVEF 화 FS 야우우대조조（P ＜0.05）；수연간예조환자6MWT 초고우대조조，단차이무통계학의의（P ＞0.05）。결론이갑쌍고대 AMI 미합병당뇨병、차미행혈관중건적환자구유심혈관보호작용。
Objective To investigate the effect and underlying mechanism of metformin on improving cardiac function in patients with acute myocardial infarction (AMI).Methods This was a single-center,ran-domized,placebo-control and single-blinded study.In total,1 28 enrolled participants with AMI were randomly assigned into the control (prescribed placebo)and interventional groups (metformin,500 mg/bid).Secondary preventive treatment of coronary heart disease was additionally prescribed for patients with AMI.Cardiac func-tional parameters at baseline level and 3-month follow-up were evaluated.Results No significant difference was observed in baseline characteristics between two groups.All participants missed the appropriate time for thrombolysis upon admission to our hospital.Cardiac parameters including LVEF,fractional shortening (FS) and 6 minute walk test (6MWT)were in the lower limit of reference value,and no significant difference was seen between two groups (P >0.05).After 3 months follow-up,the serum level of NT-proBNP was signifi-cantly lower while adiponectin was significantly higher in the interventional group as compared to those in the control group (both P <0.05).Additionally,LVEF and FS in the interventional group were superior to those in the control group (P <0.05).The outcome of 6MWT in the interventional group was better than that in the control group with no significant difference (P >0.05).Conclusion Metformin could protect cardiac func-tion in AMI patients without diabetes or revascularization.