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目的观察卡维地洛对伴发2型糖尿病的冠心病心力衰竭患者的心功能及血脂、血糖、胰岛素抵抗的影响。方法选择伴2型糖尿病的冠心病心力衰竭患者108例,随机分为两组:常规治疗组52例,卡维地洛组56例,在常规治疗基础上加用卡维地洛。药物治疗前及后3、6、12个月分别行超声心动图检查,计算校正的舒张末期容积指数(LVEDVI)、收缩末期容积指数(LVESVI)和左室射血分数(LVEF),采集空腹静脉血,测定血脂水平和空腹血糖(FPG)、胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)。结果①治疗6、12个月后卡维地洛组LVEF较对照组显著升高,LVESVI显著下降;②治疗6、12个月后卡维地洛组FINS较对照组显著升高,HOMA-IR较对照组显著降低。结论卡维地洛能明显逆转2型糖尿病并发冠心病心力衰竭患者的心室重塑、改善心功能,同时改善其血糖代谢。
Objective To investigate the effects of carvedilol on heart function, blood lipid, blood glucose and insulin resistance in patients with type 2 diabetes complicated with heart failure and heart failure. Methods A total of 108 patients with heart failure of type 2 diabetes mellitus with coronary heart disease were randomly divided into two groups: conventional treatment group (n = 52) and carvedilol group (n = 56). Carvedilol was added on the basis of routine treatment. Echocardiography was performed before and 3, 6 and 12 months after drug treatment, and the corrected LVEDVI, LVESVI and LVEF were calculated, and the fasting venous Blood was collected for determination of blood lipid levels and fasting blood glucose (FPG), insulin (FINS) and insulin resistance index (HOMA-IR). Results ① After 6 and 12 months of treatment, the LVEF of carvedilol group was significantly higher than that of the control group and the LVESVI was significantly decreased. ② After 6 and 12 months, the FINS of carvedilol group was significantly higher than that of the control group, while HOMA-IR Significantly lower than the control group. Conclusion Carvedilol can reverse ventricular remodeling in patients with type 2 diabetes mellitus complicated with heart failure and heart failure, improve cardiac function and improve blood sugar metabolism.