培哚普利与美托洛尔治疗糖尿病无症状心功能不全的疗效比较

Comparison of the effect of perindopril and metoprolol in the treatment of diabetic patients with asymptomat-ic cardiac insufficiency

目的：比较培哚普利与美托洛尔治疗糖尿病无症状心功能不全的临床疗效。方法将52例糖尿病无症状心功能不全患者按随机数字表法分为观察组和对照组，各76例。观察组给予培哚普利治疗，对照组予美托洛尔治疗，比较两组治疗前后的心功能指标、糖化血红蛋白水平、BNP水平、心功能不全发生率及药物不良反应发生情况。结果治疗前两组LVEF、Tei指数、E／A比值差异均无统计学意义（均P＞0.05）。与治疗前比较，治疗后两组以上心功能指标均明显改善（t＝5．96、4．83、4．91、10．22、5．68、5．18，均P＜0．05），但观察组患者改善更加显著（t＝5．64、4．67、5．03，均P＜0．05）。两组治疗前后糖化血红蛋白水平差异均无统计学意义（均P＞0．05），组内及组间差异均无统计学意义（均P＞0．05）。观察组治疗前后BNP分别为（515．43±58．85）pg／mL、（214．43±32．42）pg／mL，对照组分别为（513．94±59．11）pg／mL、（263．32±43．31）pg／mL，两组治疗后BNP均较治疗前明显下降（t＝23．45、17．68，均P＜0．05），但观察组患者下降更加明显（t＝6．97，P＜0．05），观察组患者心功能不全发生率为3．95％，明显低于对照组患者的14．47％（χ2＝5.03，P＜0．05）。两组药物不良反应主要表现为头晕头痛、恶心呕吐等，不良反应发生率差异无统计学意义（χ2＝0．08，P＞0．05）。结论培哚普利用于治疗糖尿病无症状心功能不全时可明显改善患者心功能，降低BNP及心功能不全发生率，临床疗效确切，安全性高。

Objective To compare the curative effect of perindopril and metoprolol in the treatment of diabetic patients with asymptomatic cardiac insufficiency.Methods According to the method of random numbers, 152 diabetic patients with asymptomatic cardiac insufficiency were divided into the observation group and control group,with 76 cases in each group.The observation group was given with perindopril treatment,while control group was given with metoprolol treatment.The cardiac function index,glycosylated hemoglobin,BNP levels,the incidence of cardiac insufficiency and the occurrence of adverse drug reactions before and after treatment were compared.Results There were no significant differences in LVEF,Tei index and E/A between two groups before treatment （all P〉0.05 ）.Compared with before treatment,the cardiac function indexes of the two groups were significantly improved after treatment（t=5.96,4.83,4.91,10.22,5.68,5.18,all P〈0.05）,but the observation group were improved more significantly（t=5.64,4.67,5.03,all P〈0.05）.Before and after treatment,there was no significant difference＆amp;nbsp;in the levels of glycosylated hemoglobin（all P〉0.05）,and the difference between the two groups was not statistically significant（all P＆gt;0.05）.The BNP levels of the observation group before and after the treatment were （515.43 ± 58.85）pg/mL and （214.43 ±32.42）pg/mL respectively,of which the control group were （513.94 ±59.11）pg/mL and （263.32 ±43.31）pg/mL respectively,and after treatment,the BNP levels of the two groups were significantly decreased（t=23.45,17.68,all P〈0.05）,of which the observation group decreased more obvious（t=6.97,P〈0.05）.The cardiac insufficiency incidence of the observation group was 3.95%,which was significantly lower than 14.47% of the control group（χ2 =5.03,P〈0.05）.The incidence of adverse drug reactions had no obvious differ-ences in both groups（χ2 =0.08,P〉0.05）.Conclusion Using perindopril in treatment of diabetic patients with asymptomatic heart function can obviously improve cardiac function,reduce the incidence of BNP and cardiac insuffi-ciency.It has the clinical curative effect and high safety.