卡维地洛治疗糖尿病合并冠心病心力衰竭的疗效观察  

Effect of Carvedilol on diabetic patients with heart failure

作　　者：陈益民[1] 刘海燕[1] 严跃红[1] 刘磊[2] 

机构地区：[1]广州医学院港湾医院内科,广东省广州510700 [2]南方医科大学珠江医院心内科

出　　处：《中国基层医药》2009年第5期779-780,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察卡维地洛对2型糖尿病并发冠心病心力衰竭的心功能及血脂、血糖、胰岛素抵抗、C-反应蛋白的影响。方法选择伴2型糖尿病并心病心力衰竭患者60例，随机分为对照组30例和治疗组30例，治疗前及治疗后1年分别观察左室舒张末期内径（LVEDD）、收缩末期内径（LVESD）、左室射血分数（LVEF）、血脂、血糖（FPG）、C-反应蛋白（CRP）、胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）、6min步行试验（6MHW）、NYHA分级。结果治疗组心功能治疗前后比较：分级：χ^2=3．12，P〈0．05；LVEF：t=2．377，P〈0．05；LVEDD、LVESD：t=2．367，t=2．289，P〈0．05；LVEF（0．50±0．08）％高于对照组（0．45±0．06）％（t=2．357，P〈0．05）；治疗组治疗后LVEDD、LVESD（50．74±2．05mm、32．17±2．32mm）均低于对照组（61．45±3．72mm、39．32±1．91mm）（t=2．217，t=2．319，P〈0．05）；治疗组治疗后C-反应蛋白（7．56±3．25）mg／L低于治疗前（10．99±4．26）mg／L（t=2．317，P〈0．05）。结论卡维地洛能明显逆转2型糖尿病并心力衰竭的心室重塑、改善心功能和血糖代谢。Objective To observe the effect of Carvedilol on cardiac function and blood lipids,blood glucose, insulin resistance in diabetic with coronary heart disease heart failure. Methods 60 patients with heart failure due to type 2 diabetes mellitus and coronary heart disease were randomly divided into two groups ： control group 30 cases and treatment group 30 cases. All the patients were checked with index of left ventricular end diastolic diameter （ LVEDD）, end-systolic diameter （ LVESD）, ejection fracture （ LVEF）, blood lipids, concentration of fastplasma glucose （FPG）, fast insulins （FINS） and HOMA-IR were observed 1 year after treatment. Results The cardiac function after treatment was significantly higher than that before treatment （ χ^2 = 3.12,P 〈 0. 05 ） ; The level of LVEF （0. 50 ± 0. 08） % significantly higher than before treatment （ 0. 37 ± 0. 07 ） % （ t = 2. 377, P 〈 0. 05 ）. The level of LVEDD （50. 74 ±2.05）mm, LVESD （32.17 ± 2. 32）mm in treatment group were significantly lower than before treatment （62. 35 ± 4. 62mm,41.22 ± 2.54mm ） （ t = 2. 367, t = 2. 289, P 〈 0. 05 ） ; The level of LVEF （ 0. 50 ± 0. 08 ） % in treatment group was higher than control group（0.45 ±0. 06）% （t =2. 357,P 〈0. 05） ;The level of LVEDD;LVESD （50. 74 ±2. 05mm,32. 17 ±2. 32mm） in treatment group were lower than the control group（61.45 ±3.72mm,39. 32 ± 1.91 mm） （ t = 2.217, t = 2. 319, P 〈 0.05 ） ; The level of C -reactive protein （ 7.56 ± 3. 25 ） mg/L in treatment group were lower than before treatment （ 10. 99 ± 4. 26） mg/L （ t = 2. 317, P 〈 0. 05 ）. Conclusion Carvedilol could reverse ventricular remodeling and improve cardiac function and blood sugar metabolism in diabetic with coronary heart disease heart failure.

关 键 词：卡维地洛 糖尿病 冠状动脉疾病 心力衰竭 

分 类 号：R587[医药卫生—内分泌] R541[医药卫生—内科学]