比索洛尔治疗2型糖尿病合并无症状心衰的临床评价  

Clinical appraisal of Bisoprolol on treatment of type2 diabetes mellitus with symptomless heart failure

作　　者：姚强[1] 丁晔[1] 李惠丽[2] 杨春云[1] 杨彪[1] 周强[1] 

机构地区：[1]湖南省怀化医学高等专科学校附属铁路医院内一科,湖南怀化418000 [2]湖南省怀化医学高等专科学校附属铁路医学院B超室,湖南怀化418000

出　　处：《中国现代医学杂志》2004年第21期97-99,101,共4页China Journal of Modern Medicine

摘　　要：目的评价比索洛尔治疗2型糖尿病合并无症状心衰的临床疗效.方法对185例2型糖尿病患者进行早期心功能检查,其中合并无症状心衰患者给予小剂量比索洛尔(2.50mg/d)治疗3个月,观察治疗前后心率(Heart Rate,HR)、血压(Blood Pressure,BP)、空腹血糖(Fasting Plasma Glucose,FPG)、空腹血浆胰岛素(Fasting Insulin,FINS)、胰岛素敏感性(Insulin Seasitivity Index,ISI)、左心房大小(Left Atrial,LA)、左心室舒张末期内径(Left Ventricular Internal Diameter,LVIDd)、左心室后壁厚度(Left Ventricular Posterior Wall Depth,LVPWd)、室间隔厚度(Interventricular Septum Depth,IVSd)、左室射血分数(Left Ventricular Ejection Fraction,LVEF)、左心室质量指数(Left Ventricular Mass Index,LVMI)及E/A峰＞1比率的变化.结果185例2型糖尿病患者中,发生无症状心衰的有57例,占30.8%;应用小剂量比索洛尔(1.25～2.50mg/d)治疗3个月后,57例患者均未出现明显不良反应,LVMI,LA,LVIDd,LVPWd和IVSd均明显小于用药前(P＜0.01),而LVEF及E/A峰＞1比率均明显增加,存在显著性差异(P＜0.01);HR、收缩压(Systole Blood Pressure,SBP)、舒张压(Diastolic Blood Pressure,DBP)均降低,差异均有显著性意义(P＜0.05);虽FPG有所升高,FINS和ISI有不同程度降低,但均无显著性差异(P＞0.05).结论2型糖尿病患者无症状者心衰的发生率高,小剂量比索洛尔对2型糖尿病合并无症状心衰的治疗效果肯定且有较好的耐受性,而对血糖、胰岛素水平等的影响较小.Objective:To evaluate the clinical efficacy of Bisoprolol on type2diabetes mellitus(2-DM)with symptomless heart failure(HF).Methods:The cardiac function of1852-DM were checked.The cases with symp-tomless HF received Bisoprolol(2.50mg/d)for3months.The changes of heart rate(HR),blood pressure(BP),fast-ing plasma glucose(FPG),fasting insulin(FINS),insulin sensitivity index(ISI),left atrial(LA),left ventricular inter-nal diameter(LVIDd),left ventricular posterior wall depth(LVPWd),interventricular septum depth(IVSd),left ven-tricular ejection fraction(LVEF),left ventricular mass index(LVMI),and the ratio of transmitral early to atria peak flow velocity(E/A)>1were observed.Results:There were57cases with symptomless HF in the1852-DM(30.8%).After taking Bisoprolol(1.25~2.50mg/d)for3months,no adverse reactions related to the drug were observed,the improvement of LVMI,LA,LVIDd,LVPWd,IVSd,LVEF and the ratio of E/A>1were significant(P<0.01);HR,systole blood pressure(SBP),diastolic blood pressure(DBP)were also decreased,they showed significant difference(P <0.05). Although the level of FPG was increased, and the levels of FINS and ISI were decreased, but they all showed no significant difference (P >0.05). Conclusions: The incidence of symptomless HF in 2-DM is high, the therapentic efficacy of micro-dosage Bisoprolol is positive and tolerant on the treatment of 2-DM with symptomless HF, the influence to the level of blood sugar and insulin is little.

关 键 词：比索洛尔 2型糖尿病 无症状心衰 

分 类 号：R587.1[医药卫生—内分泌]