普伐他汀联合美托洛尔对糖尿病合并冠心病患者心功能、糖脂代谢等相关指标的影响  

Effects of pravastatin combined with metoprolol on the cardiac function,glucolipid metabolism and other related indexes in patients with diabetes mellitus complicated with coronary heart disease

作　　者：韩莉莎 王琼[1] 李丹 王思琪 HAN Lisha;WANG Qiong;LI Dan;WANG Siqi(Department of Cardiovascular Medicine,First People's Hospital of Ziyang,Ziyang,Sichuan,China,641300)

机构地区：[1]资阳市第一人民医院心血管内科

出　　处：《分子诊断与治疗杂志》2019年第3期224-228,共5页Journal of Molecular Diagnostics and Therapy

基　　金：四川省卫计委科研项目(阿伐他汀联合益气复脉注射液治疗冠心病慢性心力衰竭患者的临床疗效观察及对sCD40、sCD146、PAPP-A的影响)(2016027)

摘　　要：目的研究普伐他汀联合美托洛尔对糖尿病合并冠心病患者心功能、糖脂代谢等相关指标的影响。方法选取本院88例糖尿病合并冠心病患者,随机分为对照组(44例)和联合用药组(44例),对照组给予美托洛尔治疗,联合用药组给予普伐他汀+美托洛尔治疗,均治疗8周,比较2组治疗前后糖代谢、脂代谢、心功能、炎症因子等指标的变化。结果治疗后,2组高密度脂蛋白胆固醇(HDL-C)、左室射血射血分数(LVEF)、舒张早期峰值速度/舒张晚期峰值速度(E/A)均显著升高(P<0.05),空腹血糖、空腹胰岛素、糖化血红蛋白、餐后2h血糖、胰岛素敏感指数、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、左室舒张末期内径(LVEDD)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子(TNF-α)、低密度脂蛋白受体(sLR11)、N末端B型利钠肽原(NT-proBNP)的水平均显著降低(P<0.05),且联合用药组上述指标变化幅度均显著大于对照组(P<0.05)。结论普伐他汀联合美托洛尔可有效改善糖尿病合并冠心病能患者心功能,改善糖代谢、脂代谢,降低炎症因子水平,从而降低患者发生心血管事件的风险,联合用药优于单一用药。Objective To investigate the effects of pravastatin combined with metoprolol on cardiac function,glucolipid metabolism and other related indexes in patients with diabetes mellitus complicated with coronary heart disease(CHD). Methods 88 patients with diabetes mellitus complicated with CHD in the hospital were selected and randomly divided into the control group(n=44)and the combined medication group(n=44). The control group was treated with metoprolol,and the combined medication group was treated with pravastatin combined with metoprolol for 8 weeks. The changes of glucose metabolism,lipid metabolism,cardiac function,inflammatory factors and other indexes were compared between the 2 groups before and after treatment. Results After treatment,the high-density lipoprotein cholesterol(HDL-C),left ventricular ejection fraction(LVEF),the early diastolic peak velocity/advanced diastolic peak velocity(E/A) were significantly increased in the 2 groups(P<0.05),while the levels of fasting blood glucose,fasting insulin,glycosylated hemoglobin,2 h postprandial blood glucose,insulin sensitivity index,total cholesterol(TC),lowdensity lipoprotein cholesterol(LDL-C),triglyceride(TG),left ventricular end diastolic diameter(LVEDD),late diastolic peak velocity(A peak),high-sensitivity C reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor α(TNF-α),low density lipoprotein receptor(sLR11),N-terminal N-terminal pro-brain natriuretic peptide(NT-proBNP)were significantly decreased(P<0.05),and the changesof the above indexes in the combined medication group were significantly greater than those in the control group(P<0.05). Conclusion Pravastatin combined with metoprolol can effectively improve the cardiac function,regulate glucose metabolism and lipid metabolism,reduce the inflammatory factors levels,thus decreasing the risk of cardiovascular events in patients with diabetes mellitus complicated with CHD. The combined medication is better than single drug.

关 键 词：糖尿病 冠心病 普伐他汀 美托洛尔 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]