卡维地洛对伴发2型糖尿病、冠心病的心力衰竭患者心功能及血脂血糖的影响

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。

Effects of carvedilol on cardiac function and blood-lipid and blood glucose in patients with heartfaUure concomitant with type 2 diabetes mellitus

Objective To study the effects of Carvedilol on cardiac function and blood-lipid and blood glucose in patients with heart failure due to type 2 diabetes mellitus and coronary heart disease. Methods 108 patients with heart failure due to type 2 diabetes mellitus and coronary heart disease were randomized into two groups：control group adn carvedilol group. After 3,6,12 months of the treatment respectively, all the patients were checked with index of end systolic volume （LVESVI）, end diastolic volume （LVEDVI）, ejection fracture （LVEF）. Blood-lipids, concentration of fast plasma glucose （FPG） , fast insulins（FINS） and HOMA-IR were ob- served. Results During follow-up,compared with the control group, the LVEF and FINS increased significantly;LVESVI and HOMA-IR reduced significantly at 12 months in the Carvedilol group. There was no significant change in blood-lipids, concentration of FPG, FINS and HOMA-IR after 12 months＇ treatment. Conclusion Carvedilol can improve the left ventricular function and remodeling in patients with heart failure due to type ：2 diabetesmellitus and coronary heart disease and has no influence on blood-lipoids,concentration of FPG,FNS and HOMA-IR.