富马酸比索洛尔对高血压或冠状动脉性心脏病伴2型糖尿病患者糖化血红蛋白水平的影响  

The impact of bisoprolol fumarate on plasma glycosylated hemoglobin levels in patients of hypertension or coronary heart disease concomitant with type 2 diabetes mellitus

作　　者：王文[1] 隋辉[1] 白曼颐[1] 郝玉明[2] 姚桦[3] 姜一农[4] 魏盟[5] 谢晋湘[1] 张学中[6] 马天容 

机构地区：[1]国家心血管病中心,中国医学科学院,阜外心血管病医院高血压室,北京100037 [2]河北医科大学第二医院 [3]广东省人民医院 [4]大连医科大学附属第一医院 [5]上海市第六人民医院 [6]中国高血压联盟,北京高血压联盟研究所 [7]默克雪兰诺有限公司

出　　处：《中华高血压杂志》2014年第2期123-128,共6页Chinese Journal of Hypertension

摘　　要：目的了解高选择性B。受体阻滞剂富马酸比索洛尔对高血压或冠状动脉性心脏病（冠心病）伴2型糖尿病患者血浆糖化血红蛋白（HbAlc）水平的影响。方法人选高血压或冠心病伴2型糖尿病患者，采用治疗前后比较的试验方法。由主管医生根据病情决定富马酸比索洛尔的用量（2．5～10．0rag／d），共治疗20周。主要终点为血浆HbAlc的变化，次要终点为空腹血糖、血脂、血压和心率的变化，并观察不良反应。结果87．2％（342／392）的患者完成研究。与基线比较，富马酸比索洛尔治疗12和20周后，HbAlc[（6．5±1．0）％、（6．5±1．1）％比（6．5±0．7）％]、空腹血糖[（6．7±1．5）、（6．7±1．7）比（6．7±1．4）mmol／L]和血脂水平差异无统计学意义（均P〉0．05）。治疗后血压和心率明显下降，未发现严重不良事件。低、中、高剂量富马酸比索洛尔的HbAlc水平差异也无统计学意义。结论富马酸比索洛尔治疗高血压或冠心病伴2型糖尿病患者20周，在明显降低血压和心率的情况下，对HbAlc水平无明显影响。Objective To assess the impact of bisoprolol fumarate, a highly selective β1 adrenoceptor antagonist, on plasma glycosylated hemoglobin （HbAlc） levels in patients of hypertension or coronary heart disease （CHD） con- comitant with type 2 diabetes mellitus （T2DM）. Methods This was a prospective, observational clinical trial that was conducted in patients of hypertension or CHD concomitant with T2DM for 20 weeks. The dose of bisoprolol fumarate （2.5--10.0 mg/dl was determined by treating cardiologists according to the patients＇ condition. The pri- mary endpoint was the change of plasma HbAlc levels, and secondary endpoint was the changes of fasting blood glu- cose （FBG）, lipid profiles, blood pressures, and heart rate, as well as adverse events. Results Altogether 392 in- dividuals were invited to participate in this trial, and 342 had completed data （response rate; 87.2%）. At the 12th and 20th weeks of treatment, no significant differences in plasma HbAlc [ （ 6.5 ± 1.0 ） % and （ 6.5±1.1 ） % vs （6.5±0.7）%], FBG [（6.7±1.5） and （6.7±1.7） vs （6.7±1.4） mmol/L-1, and lipid profiles were observed com- pared with their baseline levels Call P〈0.05）. In contrast, there were obvious reductions in blood pressures and heart rate after treatment. No adverse events were reported during the treating period. In subgroup analysis, plasma HbAlc levels did not differ significantly between patients with low-, medium-, and high-dose of bisoprolol fumarate. Conclusions Treating patients of hypertension or CHD concomitant with T2DM by bisoprolol fumarate for 20 weeks can reduce blood pressures and heart rate significantly, while there were no obvious changes for plasma HbAlc levels.

关 键 词：2型糖尿病 高血压 冠状动脉性心脏病 富马酸比索洛尔 糖化血红蛋白 

分 类 号：R544.1[医药卫生—心血管疾病] R541.4[医药卫生—内科学]