中国药师
中國藥師
중국약사
CHINA PHARMACIST
2015年
1期
110-112
,共3页
依帕司他%无症状心肌缺血%糖尿病%心率变异性
依帕司他%無癥狀心肌缺血%糖尿病%心率變異性
의파사타%무증상심기결혈%당뇨병%심솔변이성
Epalrestat%Asymptomatic myocardial ischemia%Diabetes%Heart rate variability
目的：：观察依帕司他对糖尿病无症状心肌缺血( SMI)患者心率变异性( HRV)的影响。方法：60例糖尿病SMI患者随机分为对照及观察组各30例,两组均常规予胰岛素和(或)口服降糖药物控制血糖,ARB或ACEI及CCB等降压、他汀类调脂及抗血小板聚集等治疗,不使用β受体阻断药。观察组在此基础上加服依帕司他片50 mg,po,tid ,连服4周。观察两组治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、收缩压(SBP)、舒张压(DBP)、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),以及24 h平均心率(Mean HR)、总体标准差(SDNN)、均值标准差(SDANN)、标准差均值(SDNNI)、差值的均方根(RMSSD)、差值>5ms的百分比(PNN50)等HRV指标变化情况。观察并记录治疗期间两组药品不良反应发生情况。结果：两组患者治疗后FPG、2hPG、HbA1c、SBP、DBP、TC、LDL-C等指标均较治疗前明显下降(P<0.05),而两组间主要血糖、血压、血脂等指标比较,间差异均无统计学意义(P>0.05)。观察组治疗后SDNN、SDANN、SDNNI、RMSSD、PNN50及Mean HR有明显改善(P<0.05),且显著优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论：糖尿病SMI患者临床常规治疗的基础上加用依帕司他口服可明显改善HRV相关指标,降低猝死风险,且与其他药物联用未见明显不良反应,临床安全性好。
目的：：觀察依帕司他對糖尿病無癥狀心肌缺血( SMI)患者心率變異性( HRV)的影響。方法：60例糖尿病SMI患者隨機分為對照及觀察組各30例,兩組均常規予胰島素和(或)口服降糖藥物控製血糖,ARB或ACEI及CCB等降壓、他汀類調脂及抗血小闆聚集等治療,不使用β受體阻斷藥。觀察組在此基礎上加服依帕司他片50 mg,po,tid ,連服4週。觀察兩組治療前後空腹血糖(FPG)、餐後2h血糖(2hPG)、糖化血紅蛋白(HbA1c)、收縮壓(SBP)、舒張壓(DBP)、血清總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C),以及24 h平均心率(Mean HR)、總體標準差(SDNN)、均值標準差(SDANN)、標準差均值(SDNNI)、差值的均方根(RMSSD)、差值>5ms的百分比(PNN50)等HRV指標變化情況。觀察併記錄治療期間兩組藥品不良反應髮生情況。結果：兩組患者治療後FPG、2hPG、HbA1c、SBP、DBP、TC、LDL-C等指標均較治療前明顯下降(P<0.05),而兩組間主要血糖、血壓、血脂等指標比較,間差異均無統計學意義(P>0.05)。觀察組治療後SDNN、SDANN、SDNNI、RMSSD、PNN50及Mean HR有明顯改善(P<0.05),且顯著優于對照組(P<0.05)。兩組不良反應髮生率比較差異無統計學意義(P>0.05)。結論：糖尿病SMI患者臨床常規治療的基礎上加用依帕司他口服可明顯改善HRV相關指標,降低猝死風險,且與其他藥物聯用未見明顯不良反應,臨床安全性好。
목적：：관찰의파사타대당뇨병무증상심기결혈( SMI)환자심솔변이성( HRV)적영향。방법：60례당뇨병SMI환자수궤분위대조급관찰조각30례,량조균상규여이도소화(혹)구복강당약물공제혈당,ARB혹ACEI급CCB등강압、타정류조지급항혈소판취집등치료,불사용β수체조단약。관찰조재차기출상가복의파사타편50 mg,po,tid ,련복4주。관찰량조치료전후공복혈당(FPG)、찬후2h혈당(2hPG)、당화혈홍단백(HbA1c)、수축압(SBP)、서장압(DBP)、혈청총담고순(TC)、삼선감유(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C),이급24 h평균심솔(Mean HR)、총체표준차(SDNN)、균치표준차(SDANN)、표준차균치(SDNNI)、차치적균방근(RMSSD)、차치>5ms적백분비(PNN50)등HRV지표변화정황。관찰병기록치료기간량조약품불량반응발생정황。결과：량조환자치료후FPG、2hPG、HbA1c、SBP、DBP、TC、LDL-C등지표균교치료전명현하강(P<0.05),이량조간주요혈당、혈압、혈지등지표비교,간차이균무통계학의의(P>0.05)。관찰조치료후SDNN、SDANN、SDNNI、RMSSD、PNN50급Mean HR유명현개선(P<0.05),차현저우우대조조(P<0.05)。량조불량반응발생솔비교차이무통계학의의(P>0.05)。결론：당뇨병SMI환자림상상규치료적기출상가용의파사타구복가명현개선HRV상관지표,강저졸사풍험,차여기타약물련용미견명현불량반응,림상안전성호。
Objective:To observe the effect of epalrestat on the heart rate variability in diabetes patients with silent myocardial is-chemia. Methods:Totally 60 patients were randomly divided into the control group and the treatment group with 30 cases in each. The two groups were given insulin or other routine drugs to keep blood sugar under control, ARB or ACEI and CCB to bring high blood pres-sure down, and statins to regulate lipid and anti-platelet aggregation, and both groups were without the use of beta blockers. The treat-ment group was given epalrestat 50mg three times a day for 4 weeks additionally. The indices of FPG, 2hPG, HbA1c, SBP, DBP, T-CHOL, TG, HDL-C, LDL-C and heart rate variability were observed after the treatment. Results: Compared with those before the treatment, the values of FPG, 2HPG, HbA1C, SBP, DBP, T-CHOL and LDL-c were decreased after the treatment in the two groups, and the differences were statistically significant (P <0.05), while the differences between the two groups were not obvious(P >0. 05). After the treatment, SDNN, SDANN, SDNNI, RMSSD, PNN50 and Mean HR in the treatment group were obviously im-proved, which were better than those in the control group (P<0.05). The adverse reactions in the two groups were similar (P<0. 05). Conclusion:Epalrestat can significantly improve HRV-related indicators in the diabetes patients with silent myocardial ischemi-a, which can reduce the risk of sudden death without significant adverse reactions in the combination with other drugs.
