阿卡波糖对慢性心力衰竭合并糖耐量减低患者胰岛素抵抗和心功能的影响

摘要

Objective To observe the changes of postprandial blood glucose,insulin sensitive index and cardiac function of acarbose intervention on chronic heart failure(CHF) combined with impaired glucose tolerance(IGT) patients.Methods Totally 104 CHF patients with IGT were divided into treatment group(group A) and control group(group B) according to random number table method,52 cases in each group.Two groups of patients were given standard heart failure treatment and healthy lifestyle management,on this basis,the group A was treated with acarbose,followed every 3 months for 1 times,the adverse drug reaction,blood glucose level,insulin sensitivity index,6 minutes walking distance,adverse cardiovascular events were learned.Results After treatment,the body mass index,postprandial 2 h blood glucose,fasting insulin,and postprandial 2 h insulin in group A were decreased significantly compared with before treatment(P<0.05);the fasting plasma glucose,glycosylated hemoglobin in group B were rased than before treatment,6 minutes walking distance was significantly shortened(P<0.05).Conclusion For CHF combined with IGT patients,acarbose can reduce high insulin hematic disease,improve insulin resistance,reduce the incidence of diabetes,delaying the process of heart failure.%目的 观察阿卡波糖干预慢性心力衰竭(CHF)合并糖耐量减低(IGT)患者血糖、胰岛素敏感指数及心功能变化情况.方法 将104例CHF合并IGT患者按随机数字表法分为治疗组(A组)和对照组(B组),各52 例.两组患者均给予规范心力衰竭治疗和健康生活方式管理,A组在此基础上加用阿卡波糖,每3个月随访1次,了解药物不良反应、血糖水平、胰岛素敏感指数、6 min步行距离、心血管不良事件.结果 A组治疗后体质量指数、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素较治疗前明显下降,差异均有统计学意义(P<0.05).B组治疗后空腹血糖、糖化血红蛋白较治疗前升高,6 min步行距离明显缩短,差异均有统计学意义(P<0.05).结论 对于CHF合并IGT患者,应用阿卡波糖能降低高胰岛素血症,改善胰岛素抵抗,减少新发糖尿病,延缓心力衰竭的进程.