选择性β1受体阻滞剂对高血压合并糖尿病患者糖代谢的影响  

Effect of selectiveβ1 receptor blockers on glucose metabolism in patient with essential hypertension and type 2 diabetes mellitus

作　　者：吴青青[1] 唐其柱[1] 李芳芳[1] 袁园[1] 卞洲艳[1] 

机构地区：[1]武汉大学人民医院心血管内科,湖北省武汉市430060

出　　处：《职业与健康》2014年第18期2676-2679,共4页Occupation and Health

摘　　要：目的系统评价高选择性β1受体阻滞剂(美托洛尔、阿替洛尔、比索洛尔)对原发性高血压合并2型糖尿病患者糖代谢的影响。方法计算机检索Cochrane图书馆、PubMed、Web of Knowledge、中国期刊全文数据库、万方数据库。检索时限均为建库至2013年7月。收集高选择性β1受体阻滞剂治疗高血压合并2型糖尿病患者糖代谢影响的随机对照试验(RCT)。由两位研究者按照纳入与排除标准独立对文献进行筛选、质量评价及数据提取,采用RevMan 5.0软件进行meta分析。结果共纳入相关文献9篇,其中英文文献8篇,中文文献1篇。meta分析结果显示,与对照组相比,高选择性β1受体阻滞剂组的空腹血糖(FBG)、糖化血红蛋白(HbA1c)等有统计学意义上的升高;而空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体重、C反应蛋白等相关指标,无统计学差异。结论高选择性β1受体阻滞剂在治疗原发性高血压合并2型糖尿病患者时,会导致患者血糖升高,糖耐量降低,但尚未见胰岛素抵抗发生。[Objective]To access the influence of selectiveβ1 receptor blockers（ metoprolol,atenolol,bisoprolol） on the glucose metabolism in patient with essential hypertension and type 2 diabetes mellitus（ T2DM） patients. [Methods]Cochrane Library,PubMed,Web of knowledge,CNKI and WanFang database were searched on computer to retrieve date in July 2013. The randomized controlled trails（RCTs） about high selectivity beta 1 receptor blockers in treating patients with hypertension and type 2 diabetes with inappropriate glucose metabolism were collected. The data were screened,evaluated and extracted by 2 independent researchers according to the inclusion and exclusion criteria. Meta-analysis was conducted by using RevMan5. 0 software.[Results]Totally 9 related literatures were included,eight were in English and one was in Chinese. Meta-analysis results showed that when compared with the control group,fasting blood glucose（FBG）,glycosylated hemoglobin（HbA1c） was significantly increased in the high selectivity of β1 blockers group; while index and fasting insulin（ FINS）,insulin resistance（ HOMA-IR）,weight and C-reactive protein were not significantly different between two groups. [Conclusion]Selective β1 receptor blockers can lead to the increased fasting blood glucose and impaired glucose tolerance in treating primary hypertensionwith type 2 diabetes patients,while the insulin resistance has not been observed.

关 键 词：原发性高血压 2型糖尿病 高选择性β1受体阻滞剂 系统评价 meta分析 随机对照试验 

分 类 号：R181.35[医药卫生—流行病学]