联合应用前列地尔和依帕司他对糖尿病患者心率变异性影响的评价

[摘要] 目的 探讨联合应用前列地尔和依帕司他对糖尿病患者心率变异性的影响。 方法 选择2012年1月～2013年1月本院内分泌科收治的100例2型糖尿病合并心脏自主神经病变患者作为研究对象，将其随机分为治疗组和对照组各50例，对照组接受基础治疗方案，治疗组在基础治疗方案上加用前列地尔和依帕司他，两组均持续治疗4周，并随访半年，评估临床疗效。 结果 治疗组总有效率为90.0%，对照组总有效率为56.0%，两组差异有统计学意义（χ2=14.663，P=0.0001）；治疗前两组心率变异性指标差异无统计学意义（P＞0.05），治疗后，治疗组各项指标改善效果明显好于对照组，差异有统计学意义（P＜0.05）。 结论 联合应用前列地尔和依帕司他对糖尿病患者的心率变异性改善效果明显，缓解了心脏自主神经病变症状，值得临床推广应用。

[关键词] 前列地尔；依帕司他；糖尿病；心率变异性

[中图分类号] R587.2[文献标识码] A[文章编号] 1674-4721（2014）04（c）-0066-03

Evaluation about the effect of alprostadil and epalrestat on heart rate variability in patients with diabetes

YU Jian-xin

Affiliated Hospital of Jiujiang University in Jiangxi Province,Jiujiang 332000,China

[Abstract] Objective To investigate the efficacy of alprostadil and epalrestat on heart rate variability in patients with diabetes.Methods One hundred cases of patients with type 2 diabetes cardiac autonomic neuropathy were regarded as research subjects from January 2012 to January 2013 in our hospital,and were randomly divided into treatment group (50 cases) and control group (50 cases).Basic treatment plan was implemented to the control group.Alprostadil and epalrestat was applied to the treatment group on the basis of the basic treatment.Both groups were continued for 4 weeks,and were followed for six months,then the clinical efficacy was assessed.Results The total effective rate of treatment group was 90.0%,and the control group was 56.0%,the difference was significant (χ2=14.663，P=0.0001).The heart rate variability indexes of both groups had no significant difference before treatment (P＞0.05).After treatment,the heart rate variability indexes improvement of treatment group was better than that of the control group,with significant difference (P＜0.05).Conclusion It has obvious improvement of alprostadil and epalrestat on heart rate variability in patients with diabetes.Combination therapy relieves the symptoms of cardiac autonomic neuropathy,and deserve the clinical application.

[Key words] Alprostadil;Epalrestat;Diabetes;Heart rate variability

心脏自主神经病变是糖尿病患者常见的并发症，其症状包括直立性低血压、静息性心动过速及无痛性心肌缺血，严重心脏自主神经病变使恶性心律失常、心绞痛、无痛性心肌梗死、心力衰竭、心源性休克等急性心血管事件发生率上升，使心脏猝死的发生率显著增加[1]。心率变异性是诊断心脏自主神经病变的重要指标。前列地尔及依帕司他对糖尿病周围神经病疗效显著，同样能够较好地改善心率变异性，而国内外目前对于其联合用药治疗心率变异性的报道不多[2]。本研究旨在探讨联合用药对糖尿病合并心脏自主神经病变患者的治疗效果（临床症状缓解）以及对心率变异性的影响。……