美托洛尔对舒张性心衰伴糖代谢异常患者代谢相关指标及胰岛素抵抗的影响

摘要

目的 探讨美托洛尔对舒张性心衰伴糖代谢异常患者代谢相关指标及胰岛素抵抗的影响.方法 选取本院2012年4月至2014年6月收治的1 10例舒张性心衰伴糖代谢异常的患者为研究对象,将患者抽签随机分为观察组与对照组,每组55例.对照组常规治疗,观察组在对照组基础上加用美托洛尔;比较两组治疗前后心功能、代谢相关指标及胰岛素抵抗指数.结果 (1)治疗前,两组LVEF、LVEDd及IVRT比较,差异无统计学意义(P＞0.05);治疗后,观察组LVEF为(41.25±6.47)％,显著高于对照组(P＜0.05),LVEDd及IVRT分别为(53.72±2.41) mm、(89.64±13.07) Ms,显著低于对照组(P＜0.05).(2)治疗前,两组FBG、FNS以及HOMA-IR比较,差异无统计学意义(P＞0.05);治疗后,观察组FBG、NS以及HOMA-IR分别为(5.74±0.29) mmol/L、(10.68±1.35) mU/L、(2.96±0.34),显著低于对照组(P＜ 0.05).结论 美托洛尔可明显改善舒张性心衰伴糖代谢异常患者的心功能,并且可在一定程度上改善患者糖代谢相关指标及胰岛素抵抗,值得在临床推广应用.%Objective To investigate the effect ofmetoprolol on metabolic indexes and insulin resistance in patients with diastolic heart failure complicated with abnormal glucose metabolism.Methods 110 patients with diastolic heart failure complicated with abnormal glucose metabolism treated at our hospital from April,2012 to June,2014 were selected as study objects and were randomly divided into an observation group and a control group,55 cases for each group.The control group were routinely treated;in addition,the observation group were treated with metoprolol.Before and after the treatment,the heart function,metabolic indexes,and insulin resistance index were compared between these two groups.Results Before the treatment,there were no statistical differences in LVEF,LVEDd,and IVRT between these two groups (P ＞ 0.05).After the treatment,the LVEF was (41.25±6.47)％ in the observation group,which was significantly higher than that in the control group (P ＜ 0.05);the LVEDd and IVRT were (53.72±2.41) mm and (89.64±13.07) Ms in the observation group,which were significantly lower than those in the control group (P ＜ 0.05).Before the treatment,there were no statistical differences in FBG,FNS,and HOMA-IR between these two groups (P ＞ 0.05).After the treatment,the FBG,FNS,and HOMA-IR were (5.74±0.29) mmol/L,(10.68±1.35) mU/L,and (2.96±0.34) in the observation group,which were significantly lower than those in the control group (P ＜ 0.05).Conclusions Metoprolol can improve heart function,the indexes of abnormal glucose metabolism,and insulin resistance in patients with diastolic heart failure complicated with abnormal glucose metabolism,so it is worth being clinically generalized.