【摘要】 目的探讨2型糖尿病伴左室舒张功能不全患者使用比索洛尔后B型尿钠肽(BNP)与左室舒张功能的变化。方法选取于2011年8—10月在东莞市人民医院就诊的2型糖尿病伴左室舒张功能不全患者100例(BNP≥100 pg/ml,心率>70次/min,35~75岁),采用随机数字表分为对照组和治疗组各50例。两组患者采用一致的降糖方案,在此基础上,治疗组给予比索洛尔口服,起始剂量为2.5~5.0 mg,每周调整一次剂量,2周后每月调整一次剂量,每次调整剂量为1.25~2.50 mg,使治疗组目标心率达到60~65次/min,随访1年。比较两组患者的BNP、左室射血分数(EF)、左房室瓣舒张早期血流峰值与舒张晚期血流峰值的比值(E/A)、左房容积指数(LAVI)以及心血管事件发生率。结果随访1年后,两组患者的BNP、E/A、EF间比较差异均无统计学意义(P>0.05);治疗组的LAVI和心率〔分别为(17.9±2.6)ml/m2和(62±4)次/min〕较对照组〔分别为(20.0±4.6)ml/m2和(81±7)次/min〕下降,差异均有统计学意义(P<0.05)。随访1年后,对照组出现心力衰竭症状2例,治疗组没有患者出现心力衰竭;对照组有3例新发高血压,治疗组有1例;两组各有1例出现心肌缺血;两组均无死亡病例,差异均无统计学意义(P>0.05)。结论 2型糖尿病伴左室舒张功能不全患者使用比索洛尔1年后,LAVI明显下降,左室舒张功能得到改善。更多还原

【Abstract】 Objective To investigate the changes of brain natriuretic peptide( BNP) and left ventricular diastolic function( LVDF) after medication of Bisoprolol in patients with type 2 diabetes mellitus( T2DM) and left ventricular diastolic dysfunction. Methods A total of 100 T2DM patients( BNP ≥100 pg / ml,heart rate ≥70 / min,aged 35- 75) were enrolled. They were assigned to trial and control groups,with 50 in each. All the patients were conventionally given hypoglycemic agents. The patients in the trial group were additionally given Bisoprolol,orally,initial dose of 2. 5- 5 mg,adjusted once a week,and 2 weeks later adjusted once a month,1. 25- 2. 5 mg for each adjustment,so that to keep the target heart rate being60- 65 / min. After 1 year follow up,the parameters between the two groups were compared in BNP,left ventricular ejection fraction( EF),ratio of peak of early diastolic and advanced diastolic mitral flow velocities( E / A),left atrial end- systolic volume index( LAVI),and rate of new cardiovascular events were measured. Results After 1 year follow up,no significant difference in levels of BNP,EF and E / A between two groups was found( P > 0. 05). The values of LAVI and heart rate were( 17. 9 ±2. 6) ml/m2and( 62 ± 4) / min in the trial group,being significantly lower than( 20. 0 ± 4. 6) ml / m2and( 81± 7) / min( P < 0. 05) in the control group. There were in the control group 2 cases of heart failure syndromes( 0 case in the trial),3 cases of newly diagnosed hypertension( 1 in the trial),1 case of newly diagnosed coronary heart disease( 1 in the trial),and no death case occurred in both groups( P > 0. 05). Conclusion One year medication of Bisoprolol can significantly lower LAVI in patients with type 2 diabetes and left ventricular diastolic dysfunction,and improve the left ventricular diastolic function.更多还原