摘要
目的:探讨对合并冠心病的糖尿病患者实施不同剂量美托洛尔治疗的效果。方法:选取2016年1月-2017年12月本院收治的120例合并冠心病的糖尿病患者。按照随机数字表法将其分为大剂量组(n=60)和小剂量组(n=60)。患者均按原有降糖、降脂方案治疗,大剂量组另口服美托洛尔25 mg/次,2次/d;小剂量组另口服美托洛尔12.5 mg/次,2次/d,均持续用药3个月。比较两组治疗前后的血脂、血糖状况以及临床疗效、不良反应。结果:小剂量组总有效率78.3%,稍低于大剂量组的80.0%,比较差异无统计学意义(P>0.05);治疗后,大剂量组总胆固醇、甘油三酯、低密度脂蛋白胆固醇分别为(3.4±0.5)、(1.2±0.2)、(2.3±0.3)mmol/L,均低于小剂量组的(4.2±0.3)、(1.8±0.3)、(2.9±0.3)mmol/L,大剂量组高密度脂蛋白胆固醇为(1.6±0.2)mmol/L,高于小剂量组的(1.3±0.1)mmol/L,比较差异均有统计学意义(P<0.05);治疗后,小剂量组空腹血糖、餐后2 h血糖水平分别为(6.5±0.6)、(9.2±1.3)mmol/L,均低于大剂量组的(8.3±1.2)、(10.3±1.5)mmol/L,比较差异均有统计学意义(P<0.05);两组用药不良反应病例症状均较轻,且小剂量组不良反应发生率为3.3%,低于大剂量组的16.7%(P<0.05)。结论:采取大剂量美托洛尔治疗冠心病效果更优,但降糖效果不佳,且用药安全性不高;考虑大剂量和小剂量美托洛尔治疗效果无明显差异,且小剂量治疗糖尿病合并冠心病时综合疗效更优,治疗安全性更高,运用价值更高。
Objective：To investigate the effect of different doses of Metoprolol on diabetic patients with coronary heart disease.Method：A total of 120 patients with diabetes complicated with coronary artery disease from January 2016 to December 2017 in our hospital were selected.According to the random number table method,they were divided into high-dose group（n=60） and low-dose group（n=60）.They were treated with the original hypoglycemic and lipid-lowering regimen,the high-dose group was treated with Metoprolol at a dose of 25 mg/time, 2 times/d, and low-dose group was treated with Metoprolol at a dose of 12.5 mg/time, 2 times/d,and lasted for 3 months.The blood lipids,blood glucose status before and after treatment,clinical efficacy and adverse reactions between the two groups were compared.Result：The total effective rate in low-dose group was 78.3%,which was slightly lower than 80.0% in high-dose group,but the difference was not statistically significant（P〉0.05）.After treatment,the total cholesterol,triglyceride and low density lipoprotein cholesterol in high-dose group were（3.4±0.5）,（1.2±0.2）,（2.3±0.3） mmol/L respectively,all lower than（4.2±0.3）,（1.8±0.3）,（2.9±0.3） mmol/L respectively in low-dose group,the high density lipoprotein cholesterol in high-dose group was（1.6±0.2） mmol/L,which was higher than（1.3±0.1） mmol/L in low-dose group,the differences were statistically significant（P〈0.05）.After treatment,the level of fasting blood glucose and 2 h postprandial blood glucose in low-dose group were（6.5±0.6） and（9.2±1.3） mmol/L,which were all lower than（8.3±1.2） and（10.3±1.5） mmol/L in high-dose group,the differences were statistically significant（P〈0.05）.The two groups had mild symptoms of adverse drug reactions,and the incidence of adverse reactions in low-dose group was 3.3%,lower than 16.7% in high-dose group（P〈0.05）.Conclusion：The effect of large-dose Metoprolol in treatment of coronary heart disease is better,but the effect of hypoglycemic effect is not good,and the safety of medication is not high;there is no obvious difference between the treatment effect of high-dose and low-dose of Metoprolol,and low-dose treatment of diabetes combined with coronary heart disease is better,the treatment safety is higher,and the use value is higher.
作者
田永刚
TIAN Yonggang(Jiamusi Central Hospital,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2018年第23期14-18,共5页
Medical Innovation of China
基金
黑龙江省卫生厅课题(2010-493)
关键词
冠心病
糖尿病
不同剂量美托洛尔
安全性
CoronalT heart disease
Diabetes
Different doses of Metoprolol
Safety
