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