β受体阻滞剂对心血管病患者糖代谢的影响  

The influence of β-blocker on glucose metabolism in patients with cardiovascular diseases: A Meta analysis

作　　者：郭雨龙[1] 刘爽[2] 

机构地区：[1]昆明医科大学第一附属医院心内科,650032 [2]昆明医科大学第一附属医院风湿免疫科,650032

出　　处：《心肺血管病杂志》2015年第5期405-410,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:本研究旨在应用Meta分析的方法评估现今常用的β受体阻滞剂对心血管疾病患者糖代谢的影响。方法:计算机检索Pubmed、Cochrane Library、万方数据库、维普全文数据库,纳入β受体阻滞剂对心血管疾病患者糖代谢影响的随机对照试验,应用Revman 5.2软件进行Meta分析。结果:最终纳入17项研究,共2 358例患者。应用β受体阻滞剂者与未应用者比较,治疗后糖化血红蛋白、空腹血糖及餐后,血糖均差异无统计学意义(P值分别为0.83、0.62、0.95);选择性β1阻滞剂(比索洛尔或美托洛尔)治疗后的糖化血红蛋白显著高于非选择性β阻滞剂(卡维地洛),WMD=0.12(P=0.01),但两者治疗后的空腹血糖差异无统计学意义(P=0.52);低选择性β1阻滞剂(美托洛尔)与高选择β1阻滞剂(比索洛尔或奈必洛尔)相比,治疗后空腹血糖差异无统计学意义(P=0.36)。结论:现今常用的β受体阻滞剂美托洛尔、比索洛尔及卡维地洛对糖代谢的影响不大;与美托洛尔或比索洛尔相比,卡维地洛更有利于血糖控制。Objective： To assess β-blocker＇s influence on blood glucose Metabolism in patients with cardiovascular diseases by Meta-analysis. Methods： We searched Pubmed,Cochrane Library,VIP,and WANGFANG DATA. Eligible studies were included and Meta-analysis was performed by Revman5. 2. Results： 17 studies were included,involving 2 358 patients in total. No difference was found in Hb A1 c,FBG and PBG between patients with or without β-blockers. Compared with non-selective β-blocker（ carvedilol）,patients with selective β1-blocker（ metoprolol or bisoprolol） had significantly higher Hb A1 c,WMD = 0. 12（ P = 0. 01）.No significant difference was found in FBG between patients with low-selective β-blocker（ metoprolol） or highselective β-blocker（ bisoprolol or nebivolol）,P = 0. 36. Conclusion： The β-blockers used widely today have little influence on blood glucose Metabolism. Compared with metoprolol or bisoprolol,carvedilol is more conductive to glucose control.

关 键 词：Β受体阻滞剂 糖化血红蛋白 Meta分析 血糖 心血管疾病 

分 类 号：R54[医药卫生—心血管疾病]