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比索洛尔和阿替洛尔对非胰岛素依赖型糖尿病高血压患者糖代谢的影响

[The effects of bisoprolol and atenolol on glucose metabolism in hypertensive patients with non-insulin-dependent diabetes mellitus].

作者信息

Vulpis V, Antonacci A, Prandi P, Bokor D, Pirrelli A

机构信息

Istituto di Patologia Medica, Università degli Studi di Bari.

出版信息

Minerva Med. 1991 Apr;82(4):189-93.

PMID:1673233
Abstract

Effects of bisoprolol and atenolol on glucose metabolism in hypertensive patients NIDDM. The aim of the study was to compare the antihypertensive efficacy and the effects on glucose metabolism of a new beta 1-selective beta-blocker with high beta 1 selectivity, bisoprolol and atenolol in 12 hypertensive patients (WHO classes I e II) suffering from untreated not insulin-dependent diabetes mellitus (NIDDM). According to a cross-over design after a placebo run-in period of 4 weeks, the patients were randomly allocated to receive bisoprolol 10 mg o.d. or atenolol 100 mg o.d. for 4 weeks, with a four-week wash-out period between the two active treatments. In basal condition and after each therapy an intravenous glucose tolerance test (i.v. GTT, 20 g) was performed, with evaluation of serum glucose and insulin at 0, 15, 30, 60, 90, 120 minutes and glycosuria during the test. At the same time blood pressure, heart rate (supine, upright), ECG, laboratory tests were assessed and subjective tolerability was evaluated. The glucose and insulin responses to the i.v. GTT did not significantly change to basal condition. Similarly glycosuria did not show significative increment during the test with both beta-blocking therapies. Blood pressure and heart rate values were significantly reduced (p less than 0.001) after bisoprolol and atenolol treatment. During the study no side effects were reported and laboratory tests and ECG remained substantially unchanged. These data confirm the antihypertensive efficacy of bisoprolol and atenolol and demonstrate the absence of important effects of these drugs on glucose metabolism in hypertensive patients with NIDDM.

摘要

比索洛尔和阿替洛尔对高血压合并非胰岛素依赖型糖尿病(NIDDM)患者糖代谢的影响。本研究旨在比较一种新型高β1选择性β受体阻滞剂比索洛尔与阿替洛尔对12例未经治疗的高血压(WHO I级和II级)合并非胰岛素依赖型糖尿病(NIDDM)患者的降压疗效及对糖代谢的影响。根据交叉设计,在4周的安慰剂导入期后,患者被随机分配接受比索洛尔10mg每日一次或阿替洛尔100mg每日一次,治疗4周,两种活性治疗之间有4周的洗脱期。在基础状态及每种治疗后进行静脉葡萄糖耐量试验(i.v.GTT,20g),在0、15、30、60、90、120分钟时评估血清葡萄糖和胰岛素,并在试验期间评估糖尿情况。同时评估血压、心率(仰卧位、直立位)、心电图、实验室检查,并评价主观耐受性。静脉葡萄糖耐量试验的葡萄糖和胰岛素反应与基础状态相比无显著变化。同样,两种β受体阻滞剂治疗期间糖尿在试验中也未显示出显著增加。比索洛尔和阿替洛尔治疗后血压和心率值显著降低(p<0.001)。研究期间未报告副作用,实验室检查和心电图基本保持不变。这些数据证实了比索洛尔和阿替洛尔的降压疗效,并表明这些药物对高血压合并NIDDM患者的糖代谢无重要影响。

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