选择性和非选择性β-受体阻滞剂对冠心病合并糖尿病患者血糖及血脂代谢的影响

Effect of selective and non-selective beta-blockers on blood glucose and blood lipid metabolism in patients with coronary heart disease combined with diabetes mellitus

目的：比较选择性β-受体阻滞剂（琥珀酸美托洛尔）和非选择性β-受体阻滞剂（卡维地洛）对冠心病合并糖尿病患者血糖、血脂代谢的影响。方法选择2015年3月至2015年9月经冠状动脉造影确诊为冠心病并符合2型糖尿病诊断标准的120例患者为研究对象，将入组患者按照随机数字表法分为两组。治疗组给予卡维地洛治疗，对照组给予琥珀酸美托洛尔缓释片治疗，比较两组患者心率控制情况及血糖、血脂水平。结果两组患者治疗后3个月心率比较差异未见统计学意义（P﹥0.05），但治疗后空腹血糖、胰岛素、胰岛素敏感指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇指标比较差异有统计学意义（P﹤0.05）。结论卡维地洛控制心率作用与琥珀酸美托洛尔相似，但其对于糖脂代谢的调节疗效更优，更适合于冠心病合并糖尿病患者。

Objective To compare the effect of selective bata-blocker（ carvedilol ）and non-se-lective bata-blocker（ metoprolol ）on blood glucose and blood lipid metabolism in patients with coronary heart disease combined with diabetes mellitus. Methods From March 2015 to September 2015,120 pa-tients with type 2 diabetes mellitus combined with coronary heart disease diagnosed by coronary angiogra-phy were selected as research objects,patients were divided into two groups according to random number table method. Patients in treatment group were treated with carvedilol,and patients in control group were treated with metoprolol sustained-release tablets,the heart rate control level,blood glucose and blood lip-id levels were compared between the two groups. Results After treatment for 3 months,there was no significant difference in heart rate between the two groups（ P﹥0 . 05 ）,but there were significant differ-ences in the levels of fasting blood glucose,insulin,insulin sensitivity index,total cholesterol,triglycer-ide,low density lipoprotein cholesterol and high density lipoprotein cholesterol between the two groups （P﹤0. 05）. Conclusions Carvedilol and metoprolol in heart rate control are similar,but the regulation effect of carvedilol on glucose and lipid metabolism are better and more suitable for patients with coronary heart disease and diabetes.