国产比索洛尔对高血压2型糖尿病患者糖代谢的影响

目的观察国产比索洛尔对高血压合并2型糖尿病患者糖代谢及血压的影响情况。方法将符合纳入标准的高血压合并2型糖尿病患者随机分组。观察治疗前后患者糖化血红蛋白(HbA1c)、空腹血糖、糖耐量和血压等的变化。结果共有92例患者完成研究,其中比索洛尔组47例,卡托普利组45例。治疗前和经12周治疗后两组HbA1c、空腹血糖、餐后2h血糖、收缩压和舒张压差异均无统计学意义(P=0.05)。结论本研究表明比索洛尔作为高选择性β1受体阻滞剂,对于原发性高血压合并2型糖尿病患者糖代谢无明显不良影响,同时具有良好的降压效果。

The effect long-term administration of a selective beta1 blocker bisoprolol on glucose metabolism in patients with essential hypertensive and type 2 diabetes mellitus

OBJECTIVE: To investigate the effects of bisoprolol on glucose metabolism and blood pressure in essential hypertensive patients with type 2 diabetes mellitus. METHODS: A total of 92 hypertensive patients with type 2 diabetes on stable antidiabetic therapy with HbAlc less than 7% were recruited. In a randomized, open trial the patients were treated for 12 weeks with bisoprolol or captopril following a 1-week placebo run-in period, the main parameters measured were HbA1c, fasting blood glucose and 2-hour postprandial glucose following a standard dinner as well as systolic and diastolic blood pressure. RESULTS: There were no differences in HbA1 (6.0 +/- 0.8)% vs (6.2 +/- 0.8)%, P > 0.05], fasting glucose (7.0 +/- 1.8) mmol/L vs (7.0 +/- 1.9) mmol/L, P > 0.05], 2-hour postprandial blood glucose (10.7 +/- 2.5) mmol/L vs (11.2 +/- 3.4) mmol/L, P > 0.05], systolic blood pressure (147.3 +/- 9.7) mm Hg (1 mm Hg = 0.133 kPa) vs (146.2 +/- 8.3) mm Hg, P > 0.05] and diastolic blood pressure (88.3 +/- 8.9 mm Hg vs 87.8 +/- 7.9 mm Hg, P > 0.05) between the bisoprolol and captopril group before treatment. After administration of bisoprolol or captopril, there were still no differences between these two groups in HbA1c (5.7 +/- 0.9)% vs (5.7 +/- 1.1)%, P > 0.05], fasting blood glucose (6.8 +/- 1.6) mmol/L vs (6.4 +/- 2.1) mmol/L, P > 0.05], 2-hour postprandial glucose (10.0 +/- 2.9) mmol/L vs (10.2 +/- +/- 2.9)mmol/L, P > 0.05], systolic blood pressure (124.8 +/- 10.6) mm Hg vs (126.6 +/- 7.8) mm Hg, P > 0.05] and diastolic blood pressure (74.5 +/- 7.7) mm Hg vs (77.6 +/- 7.6) mm Hg, P = 0.05]. CONCLUSIONS: Based on these results, bisoprolol appears to be a beta1-selective blocker possessing a satisfactory antihypertensive effect without any adverse effects on glucose metabolism and is therefore a choice for treating hypertensive patients with type 2 diabetes mellitus.