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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。
Objective: To investigate the efficacy and safety of carvedilol in elderly patients with type 2 diabetes mellitus (DM) complicated with chronic heart failure (CHF). Methods: Seventy-three elderly DM patients complicated with CHF were randomly divided into the carvedilol group (n = 45) and the control group (n = 28). The control group was given routine treatment and the carvedilol group was given carvedilol on the basis of routine treatment. The patients were followed up for 12 months. The heart rate, blood pressure, heart function, blood glucose, blood lipid, cardiac events and drug resistance were compared between the two groups after treatment. Results: After treatment, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and left ventricular ejection fraction improved significantly in the carvedilol group (P <0.05); a total of 6 cases of cardiac death occurred during follow-up There were 12 cases of re-hospitalization after heart failure exacerbated, and there were significant differences in the incidence of total cardiac events between the two groups (P <0.05). No hypoglycemia, edema and atrioventricular block were observed in the two groups. , Serum creatinine, fasting blood glucose, glycosylated hemoglobin and LDL were not significantly different (P> 0.05). CONCLUSION: Carvedilol has good safety and efficacy in the treatment of elderly patients with diabetes mellitus complicated with CHF. It can improve the cardiac function and reduce the incidence of cardiac events in patients with diabetes without affecting blood glucose and lipid metabolism.