二甲双胍对糖尿病心肌病慢性充血性心力衰竭及心肌灌注的影响.docVIP

·601 · · 论 著 · 二甲双胍对糖尿病心肌病慢性充血性心力衰竭及 心肌灌注的影响 游琼，吴铿 【摘要】 目的 探讨二甲双胍对糖尿病心肌病慢性充血性心力衰竭及心肌灌注的影响。方法 将66例糖尿病心 肌病患者随机分为二甲双胍组(36例)和安慰剂组(30例),利用门控单电子发射计算机体层扫描 (SPECT) 进行心 功能定量分析及心肌灌注图像可视化分析，随访12个月。 结果 两组患者治疗后运动试验持续时间、总做功负荷、毛 花甙丙每月用量、心力衰竭每月发作次数、总运动负荷评分 (SSS 评分)、总静息评分 (SRS 评分)、收缩期室壁厚度 (SWT)、 室壁运动评分指数 (WMI) 和左室射血分数 (LVEF) 比较，差异均有统计学意义 (P0.05); 两组患者治 疗后心率和收缩压比较，差异均无统计学意义 (P0.05)。 结论 二甲双胍不仅能改善心肌灌注，而且能在不影响心 率和血压的基础上改善糖尿病心肌病患者心功能。 【关键词】 二甲双胍；糖尿病；心力衰竭，充血性；心肌灌注 【中图分类号】 R587.1 【文献标识码】 A 【文章编号】1007-9572(2011)02-0601-03 Effect of Metformin on Diabetic Cardiomyopathy Chronic Congestive Heart Failure and Myocardial Perfusion YOU Qiong,WU Keng. Diuision of Cardiology,Department of Internal Medicine,Affiliated Hospital of Guangdong Medieal College, Zhanjiang 524001,China 【Abstract】 Objective To study the effect of metformin on diabetic cardiomyopathy(DC) chronic congestive heart fail- ure(CCHF) and myocardial perfusion. Methods Sixty - six DC patients were randomized into groups A(treated with metform- in, n=36),B(treated with placebo,n=30). Single- photon Emission Computed Tomography(SPECT) was used to perform heart function quantitative analysis and cardiac perfusion imaging visual analysis. Follow -up lasted 12 months. Results There was significant difference between 2 groups in exercise test duration, total power load, monthly lanatoside C dosage,monthly a- cute exacerbation frequency of CCHF summed stress score(SSS), summed resting score(SRS),systolic wall thickness (SWT), wall motion index(WMI),left ventricular ejection fraction(LVEF)(P0.05);no significant difference was noted in post - treatment heart rate and systolic blood pressure between 2 groups(P0.05). Conclusion Metformin can improve not only myocardial perfusion but also cardiac function in DC patients, not influencing heart rate or blood pressure. 【Key words】 Metformin; Diabetes mellitus; Heart failure,congestive; Myocardial perfusion 1972年， Rubler等在无明显冠状动脉粥样硬化的糖尿 病患者中观察到一种特异性心肌病。1974年， Robert 等 [ 通 过进一步研究