卡维地洛治疗老年糖尿病并发慢性心力衰竭的临床疗效和安全性观察

目的:探讨卡维地洛治疗老年2型糖尿病(DM)并发慢性心力衰竭(CHF)患者的疗效及安全性.方法:73例老年DM并发CHF患者,随机分为卡维地洛组45例和对照组28例,对照组采用常规治疗,卡维地洛组在常规治疗基础上加服卡维地洛.随访12个月,比较治疗后2组患者的心率、血压、心脏功能以及血糖、血脂等变化,心脏事件以及药物耐受性.结果:治疗后,卡维地洛组左室舒张末期内径、左室收缩末期内径及左室射血分数较对照组改善明显(P＜0.05);随访期间总共发生心源性死亡6例,因心力衰竭加重而再次住院12例,2组总心脏事件发生率差异有统计学意义(P＜0.05);2组均未发生低血糖反应、水肿及高度房室传导阻滞,2组患者的血压、血清肌酐水平、空腹血糖、糖基化血红蛋白以及LDL等差异均无统计学意义(P＞0.05).结论:卡维地洛在老年糖尿病并发CHF患者治疗中具有良好的安全性和有效性,能改善患者的心脏功能,降低心脏事件发生率,对血糖、血脂代谢没有明显影响.

Clinical safety and efficacy of carvedilol in elderly patients with diabetes mellitus and chronic heart failure

Objective:To investigate the clinical safety and efficacy of carvedilol in treatment of elderly patients with type 2 diabetes mellitus(T2DM) and chronic heart failure(CHF).Method:Seventy-three elderly patients with T2DM and CHF were randomly divided into two groups: control group(n=28) received conventional therapy,while carvedilol group(n=45) was treated with additional carvedilol.Heart rate,blood pressure,cardiac function,blood glucose and cholesterol,heart event,and drug tolerance were compared in two groups during 12-month follow-up.Result:After treatment,the changes of LVEDD,LVESD,LVEF and cardiac function in carvedilol group were improved significantly compared with control group(P<0.05).During follow-up,six cases in all died from cardiac incidences,and twelve cases were admitted again for aggravated heart failure.Incidence of cardiac event in carvedilol group was a significantly lower than that in control group(P<0.05).No cases exhibited hypoglycemia,edema and advanced A-V block in both groups.There were no statistical difference in blood pressure,serum creatinine levels,fasting blood glucose,glycosylated haemoglobin and low-density cholesterol between two groups(P>0.05).Conclusion:Carvedilol may be a safe and effective drug in the treatment of elder patients with T2DM and CHF by improving heart function,reducing incidence of cardiac event,and being lack of interference on blood glucose and lipid metabolism.