不同剂量美托洛尔治疗不稳定型心绞痛的疗效及对血糖影响的临床研究

Clinical Study on Therapeutic Effect of Different Doses of Metoprolol in the Treatment of Unstable Angina Pectoris and Its Influence on Blood Sugar

目的:探讨不同剂量的美托洛尔治疗不稳定型心绞痛的疗效,及对血糖水平的影响。方法:选择2014年12月-2015年12月年来本院进行治疗的120例不稳定型心绞痛合并2型糖尿病患者进行调查分析,分为低剂量组、常规剂量组和高剂量组,每组各40例。低剂量组采用美托洛尔缓释片23.75 mg口服,1次/d;常规剂量组予美托洛尔缓释片47.5 mg口服,1次/d;而高剂量组予美托洛尔缓释片95 mg口服,1次/d。结果:治疗3个月后,高剂量组和常规剂量组空腹血糖水平明显低于治疗前,差异均有统计学意义(P<0.05),但餐后2 h的血糖水平与治疗前比较无明显变化,而低剂量组的空腹血糖与餐后2 h血糖治疗前后比较差异均无统计学意义(P>0.05);与低剂量组相比,高剂量组、常规剂量组治疗后的空腹血糖均明显降低,差异均有统计学意义(P<0.05)。常规剂量组发生不良反应的例数明显少于高、低剂量组,高剂量组、常规剂量组、低剂量组的不良反应率分别为57.5%、32.5%、65.0%,比较差异均有统计学意义(P<0.05)。高剂量组的总有效率90.0%高于低剂量组62.50%与常规剂量组85.0%,高剂量组及常规剂量组与低剂量组比较差异均有统计学意义(u=2.7435、2.1888,P=0.0061、0.0286),高剂量组和常规剂量组比较差异无统计学意义(P>0.05)。结论:美托洛尔治疗不稳定型心绞痛有效,安全的剂量范围易于在临床应用,具有广泛的实用价值,值得在临床推广研究。

Objective：To investigate the efficacy of different doses of Metoprolol in the treatment of unstable angina pectoris, and their effects on blood glucose levels.Method：120 patients of unstable angina pectoris with type 2 diabetes were selected from December 2014 to December 2015 in our hospital for treatment,they were investigated and divided into low dose group,conventional dose group and high dose group,40 cases in each group.Low dose group received Metoprolol sustained-release tablets was 23.75 mg oral,conventional dose group received Metoprolol sustained-release tablets was 47.5 mg oral, and high dose group was given Metoprolol sustained-release tablets of 95 mg oral,which all oral once a day.Result：After treatment of 3 months, the fasting blood glucose levels of high dose group and conventional dose group were significantly lower than that before treatment,the differences were statistically significant（P0.05）,but 2 h postprandial blood glucose levels compared with before treatment had no obvious change;the fasting blood glucose and 2 h after meal blood sugar of low dose group comparison before and after treatment,there were no significant differences（P0.05）.After treatment,compared with the low dose group,the fasting blood glucose of high dose group and conventional dose group significantly decreased,the differences were statistically significant（P0.05）.The number of common adverse reaction of conventional dose group was significantly less than the high and low dose groups, adverse reactions rates of high dose group and conventional dose group and low dose group were respectively 57.50%, 32.50% and 65.0%,the differences were statistically significant（P0.05）.The total effective rate of high dose group was 90.00% higher than that low dose group of 62.50% and conventional dose group of 85.00%, high dose group and conventional dose group compared with low dose group,the differences were statistically significant（u=2.7435,2.1888;P=0.0061,0.0286）. Compared the effective rate of high dose group and routine dose group,the difference was no statistically significant（P0.05）.Conclusion：Metoprolol in the treatment of unstable angina pectoris is effectively,the safe dose range easily in clinical application,with extensive practical value and it is worth to be popularized in clinical research.