期刊文献+

卡维地洛对伴2型糖尿病的老年心力衰竭患者左室功能的影响

Effects of carvediol on left ventricular function in elderly patients with heart failure complicated with type 2 diabetes mellitus
下载PDF
导出
摘要 目的研究卡维地洛对伴2型糖尿病的老年充血性心力衰竭(CHF)患者左室功能、炎症因子及血糖、血脂的影响。方法 95例伴2型糖尿病的老年CHF患者分为常规治疗组(对照组)及卡维地洛治疗组,对照组给予利尿剂、血管紧张素转换酶抑制剂及强心剂治疗,卡维地洛组在常规治疗的基础上加用卡维地洛,剂量由2.5 mg,2次/d开始,渐增至10 mg,2次/d,2组病人均给予口服降糖药或注射胰岛素控制血糖。治疗前及治疗6月后抽血查空腹血糖(FBG)、血脂、内皮素1(ET-1)、肿瘤坏死因子α(TNFα-)及尿酸(UA)等,超声心动图测量左室舒张末容积及左室收缩末容积并计算左室射血分数(LVEF)。结果与治疗前相比,2组病人治疗后LVEF升高,ET-1、TNFα-及UA减低(P<0.01或P<0.05),上述改变在卡维地洛治疗组更显著,2组间亦有显著性差异(P<0.05),而2组病人的FBG、血脂在治疗前后无显著改变(P>0.05)。结论卡维地洛可显著改善伴2型糖尿病的老年CHF患者的左室功能,降低炎症因子水平,保护心肌细胞,且对血糖、血脂代谢无明显影响。 Objective To study the effect of carvedilol on left ventricular function,inflammatory factors,blood-lipids and blood glucose in elderly patients with congestive heart failure(CHF) complicated with type 2 diabetes mellitus.Methods Ninety-five elderly patients with CHF complicated with type 2 diabetes mellitus were divided into routine treatment group(control group) and carvedilol group.The patients in control group were treated with diuretic,angiotensin-converting enzyme inhibitor and digoxin.Another group was treated with carvedilol on the basis treatment of control group.The endothelin-1(ET-1),tumor necrosis factor α(TNF-α),uric acid(UA),blood-lipids and fasting blood glucose(FBG) were measured.Ultrasonic cardiography measurement was performed and left ventricular ejection fraction(LVEF) was calculated before and after 6 months therapy.Results After treatment,LVEF was increased and serum levels of ET-1,TNF-α and UA were decreased significantly in both groups(P0.01 or P0.05).And in carvedilol group,the above changes were more obvious than those in control group(P0.05).There were no significant changes in blood-lipids and FBG before and after 6 months treatment(P0.05).Conclusions Carvedilol shows more significant effect on improving cardiac function and decreasing inflammatory factors in elderly patients with CHF complicated with type 2 diabetes mellitus,and carvedilol has no influence on blood glucose and blood-lipids.
出处 《实用老年医学》 CAS 2011年第2期144-146,共3页 Practical Geriatrics
关键词 卡维地洛 心力衰竭 左室功能 2型糖尿病 老年人 carvedilol heart failure left ventricular function type 2 diabetes mellitus aged
  • 相关文献

参考文献6

  • 1黄元铸.糖尿病合并冠心病研究进展[J].实用老年医学,2007,21(5):292-293. 被引量:2
  • 2杨田,沈萍,赵仙先.卡维地洛的药理作用研究进展[J].国外医学(药学分册),2002,29(3):148-151. 被引量:11
  • 3Rossig L,Haendeler J,Mallat Z,et al.Congestive heart failure induces endothelial cell apoptosis: protective role of carvedilol. Journal of the American College of Cardiology . 2001
  • 4Cleland SJ,Petrie JR,SmallM, eta l.Insulin action is associated with endothelial function in hypertention and type 2 diabet. Journal of Hypertension . 2000
  • 5Ohta Y,Watanabe K,Nakazawa M,et al.Carvedilol enhances atrial and brain natriuretic peptide mRNA expression and release in rat heart. Journal of Cardiovascular Pharmacology . 2000
  • 6Bakris GL,Fonseca V,Katholi RE,et al.Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. Journal of the American Medical Association, The . 2004

二级参考文献22

  • 1Kurz T, Richardt D, Gorge B, et al. Differential effects of carvedilol on norepinephrine release in normoxic and ischemic heart[J]. J Cardiovasc Pharmacol, 2000, 36(1):96- 100.
  • 2Lechat P, Chalon S, Cucherat M, et al. Meta-analysis of randomized clinical trials on β-blocker treatment in heart failure[J]. Circulation, 1996, 94(Suppl 1) :1665 - 1668.
  • 3Krum H, Ninio D, MacDonald P. Baseline predictors of tolerability to carvedilol in patients with chronic heart failure [J]. Heart, 2000, 84(6) :615 - 619.
  • 4Doughty RN, Rodger A, Sharpe N, et al. Effects of β-blocker therapy on mortality in patients with heart failure. A systematic overview of randomized controlled trials[J]. Eur Heart J, 1997, 18(4) :560- 565.
  • 5Bristow MR. Mechanism of action of β-blocking agents in heart failure[J]. Am J Cardiol, 1997, 80(11A) :26L-40L.
  • 6Stoschitzky K, Koshucharova G, Zweiker R, et al. Differing β-blocking effects of carvedilol and metoprolol[J]. Eur J Heart Fail, 2001, 3(3) :343 - 349.
  • 7Colucci WS. Molecular and cellular mechanisms of myocardial failure[J]. Am J Cardiol, 1997, 80(11A): 15L-25L.
  • 8Oettl K, Greilberger J, Zangger K, et al. Radical-scavenging and iron-chelating properties of carvedilol, an antihypertensive drug with antioxidative activity[J]. Biochem Pharmacol, 2001, 62(2) :241 - 248.
  • 9Matsuda Y, Akita H, Terashima M, et al. Carvedilol improves endothelium-dependent dilatation in patients with coronary artery disease[J]. Am Heart J, 2000, 140(5):753 - 759.
  • 10Santos DJ, Moreno AJ. Inhibition of heart mitochondrial lipid peroxidation by non-toxic concentrations of carvedilol and its analog BM-910228[J]. Biochem Pharmacol, 2001,61(2): 155 - 164.

共引文献11

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部