Mikhailidis D P, Barradas M A, Hutton R A, Jeremy J Y, Sabur M, Dandona P
Diabetes Res. 1985 May;2(3):127-34.
Several haemostatic and metabolic variables were monitored during insulin stress tests (ISTs), which were preceded by placebo, nadolol or propranolol ingestion for 10 days. Nadolol administration blocked the rise in plasma factor VIII: RAg concentrations, but no significant changes were observed in platelet aggregation/thromboxane A2 release. Propranolol administration reduced the significance, but not the magnitude, of the plasma factor VIII:Rag rise and also marginally inhibited platelet aggregation/TXA2 release. Both nadolol and propranolol inhibited the hypokalaemia of hypoglycaemia and retarded the recovery of plasma glucose concentrations, probably by inhibiting lipolysis (as indicated by serum nonesterified fatty acid concentrations). Both nadolol and propranolol often masked and delayed the onset of the symptoms of hypoglycaemia. Beta-blockers may exert beneficial effects by modifying haemostatic variables and by preventing hypokalaemia during stressful situations, such as hypoglycaemia or myocardial infarction, both in diabetics and in non-diabetics. However, any benefit must be balanced against the risk of masking, and possibly increasing the incidence of, hypoglycaemia in diabetics.
在胰岛素应激试验（ISTs）期间监测了多个止血和代谢变量，试验前给予安慰剂、纳多洛尔或普萘洛尔10天。给予纳多洛尔可阻断血浆因子VIII：相关抗原（RAg）浓度的升高，但血小板聚集/血栓素A2释放未见显著变化。给予普萘洛尔可降低血浆因子VIII：Rag升高的显著性，但不影响其幅度，并且还轻微抑制血小板聚集/TXA2释放。纳多洛尔和普萘洛尔均抑制低血糖导致的低钾血症，并延缓血浆葡萄糖浓度的恢复，可能是通过抑制脂肪分解（如血清非酯化脂肪酸浓度所示）。纳多洛尔和普萘洛尔常常掩盖并延迟低血糖症状的发作。β受体阻滞剂可能通过改变止血变量以及在应激情况下（如低血糖或心肌梗死）预防低钾血症而发挥有益作用，无论是糖尿病患者还是非糖尿病患者。然而，任何益处都必须与掩盖糖尿病患者低血糖症状以及可能增加低血糖发生率的风险相权衡。
