中国药物警戒 ›› 2016, Vol. 13 ›› Issue (1): 9-12.

• 基础与临床研究 • 上一篇    下一篇

二甲双胍对高血压合并2型糖尿病患者心室重塑的影响

靳新民   

  1. 内蒙古医科大学附属医院内科 ,内蒙古 呼和浩特010059
  • 收稿日期:2015-08-12 修回日期:2016-02-25 出版日期:2016-01-08 发布日期:2016-02-25
  • 作者简介:靳新民, 女, 本科, 副主任护师, 内科。

Effects of Metformin on Ventricular Remodeling in Patients with Primary Hypertension and Type 2 Diabetes Mellitus

JIN Xin-min   

  1. Medical Examination Center, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Huhehaote 010059, China
  • Received:2015-08-12 Revised:2016-02-25 Online:2016-01-08 Published:2016-02-25

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摘要： 目的 探讨口服二甲双胍对高血压合并 2型糖尿病患者心室重塑的影响。方法 选择 2012年 5月 ~2013年 4月我院收治的高血压合并 2型糖尿病患者 162例 ,根据在随访期内是否服用二甲双胍将患者分为实验组（ 75例）和对照组（ 87例） ,再根据服用二甲双胍时间对实验组患者进行亚组分析 ,分析患者的临床资料及超声心动图检测结果 ,评价用药时长和高血压病程对患者心室重塑的影响。结果 服药后再次就诊时 ,实验组患者的IVSD、 LVPWD及 LVMI较对照组患者明显降低（ P=0.002, 0.039, 0.008）,是否服用二甲双胍是 LVPWD和 LVMI的独立影响因素（P=0.031, 0.043） ;服用二甲双胍≥ 12月组患者与对照组患者之间 LVMI水平差异具有统计学意义（ P=0.038）,服用二甲双胍时长是 LVMI的独立影响因素（ P=0.039） ;实验组高血压病程 <5年患者的 LVMI与高血压病程≥ 5年患者的IVSD、LVMI较对照组患者明显降低（ P=0.032, 0.026, 0.023）。结论 二甲双胍具有抑制高血压合并 2型糖尿病患者心肌肥厚 ,进而改善心室重塑的临床效果 ,对于高血压病程和服用时间较长患者的改善效果可能更为显著。

关键词: 高血压合并2型糖尿病, 二甲双胍, 心肌肥厚, 心室重塑

Abstract: Objective To explore the effects of metformin on ventricular remodeling in patients with primary hypertension and type 2 diabetes mellitus. Methods 162 patients with primary hypertension and type 2 diabetes mellitus treated in our hospital from May 2012 to April 2013 were selected. The patients were divided into test group (n=75) and control group (n=87) according to whether used metformin or not. Subgroup analyses of the patients in the test group were used with the time of taking metformin,the clinical and echocardiographic data of 162 patients were retrospectively analyzed to assess the effect of hypertension duration and duration of drug usage on ventricular remodeling in patients. Results After treatment, the LVMI, LVPWD and IVSD in the test group were significantly lower than those in the control group (P=0.002, 0.039, 0.008), metformin is an independent factor for LVMI and LVPWD (P=0.031, 0.043). The difference of LVMI level between taking metformin ≥12 months group and control group patients was statistically significant (P=0.038). Taking metformin time is the independent factor of LVMI (P=0.039), the LVMI of the patients with course of hypertension < 5 years and the IVSD、LVMI of the patients with course of hypertension ≥5 years in test group were significantly lower than the control group (P=0.032, 0.026, 0.023). Conclusion Metformin may attenuate left ventricular hypertrophy of patients with primary hypertension and type 2 diabetes mellitus, and then improve the ventricular remodeling. The improvement effect of the patients with longer course of hypertension and longer time of medication may be more significant.

Key words: hypertension combined with type 2 diabetes mellitus, metformin, myocardial hypertrophy, ventricular remodeling

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