刘补尚

[摘要] 目的 探讨卡维地洛治疗糖尿病合并心力衰竭的效果。方法 选取该科2015年9月—2017年9月收治的糖尿病合并慢性心力衰竭患者102例，随机分为两组各51例，对照组给予常规治疗，观察组在对照组的基础上给予卡维地洛，比较療效。结果 观察组总有效率为88.2%，明显优于对照组72.5%（P<0.05）；观察组LVEF（56.91±6.13）%较对照组显著升高，FPG（5.05±0.42）mmol/L、LVEDD（48.56±1.90）mm、LVESD（33.65±2.14）mm较对照组显著降低（P<0.05）。结论 卡维地洛可有效改善糖尿病合并心力衰竭患者的心功能，提高预后，值得应用。

[关键词] 卡维地洛；糖尿病；心力衰竭；治疗效果

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2018）02（b）-0076-02

Clinical Analysis of Carvedilol in the Treatment of 51 Cases of Diabetes Mellitus Complicated with Heart Failure

LIU Bu-shang

Cardiovascular Department， Section Two， Changchun Central Hospital， Changchun， Jilin Province， 130000 China

[Abstract] Objective This paper tries to investigate the effect of carvedilol in the treatment of diabetes with heart failure. Methods 102 patients with diabetes and chronic heart failure admitted to this hospital from September 2015 to September 2017 were selected. They were randomly divided into two groups of 51 patients in each. The control group was given conventional treatment. The observation group was given carvedilol on the basis of the control group. The curative effect of the two groups were compared. Results The total effective rate was 88.2% in the observation group， which was significantly better than that in the control group（72.5%）（P<0.05）； the LVEF （56.91±6.13）% in the observation group was significantly higher than that in the control group， FPG（5.05±0.42）mmol/L， LVEDD（48.56±1.90）mm and LVESD（33.65±2.14）mm， were significantly lower than those in the control group（P<0.05）. Conclusion Carvedilol can effectively improve the heart function of patients with diabetes mellitus complicated with heart failure， improve the prognosis and is worthy of application.

[Key words] Carvedilol； Diabetes； Heart failure； Therapeutic effect

心力衰竭是多种心脏病的最终末阶段[1]，也是临床常见的危重症，随着近年来对心衰发病机制的深入探讨，糖尿病作为心血管疾病的独立危险因素，可破坏已形成动脉硬化斑块的稳定性，加速动脉粥样硬化形成，同时影响对血糖的控制，进一步加重患者病情。据统计[2]，糖尿病患者发生心力衰竭的机率较非糖尿病患者高4倍，且糖尿病患者发生首次心力衰竭事件的时间比非糖尿病患者早4～5年。两者合并发生时，往往可影响治疗效果和预后。临床研究表明[3]，β受体阻滞剂对提高心功能，降低病死率，改善患者预后有积极的作用。为探讨糖尿病合并心力衰竭的有效治疗方法，该科对2015年9月—2017年9月收治的51例糖尿病合并心力衰竭患者进行卡维地洛治疗，观察其治疗效果，报道如下。

1 资料与方法

1.1 一般资料

选取该科收治的糖尿病合并慢性心力衰竭患者102例为观察对象，随机将患者分为两组各51例，观察组男31例，女20例，年龄51～85岁，平均（70.3±2.4）岁；心衰病程7个月～8年，平均（4.9±1.1）年，糖尿病病程4～17年，平均（7.2±1.8）年；NYHA心功能分级Ⅱ级16例，Ⅲ级24例，Ⅳ级11例。……