【摘要】：目的:比較瑞格列奈分別聯(lián)合氨氯地平、氯沙坦鉀治療2型糖尿病(T2DM)合并原發(fā)性高血壓的療效和安全性。方法:306例T2DM合并原發(fā)性高血壓患者隨機分為A組(153例)和B組(153例)。兩組患者均采用常規(guī)飲食運動療法及胰島素治療,入院后給予瑞格列奈片1 mg,口服,每日1次;在此基礎(chǔ)上,A組患者給予苯磺酸左旋氨氯地平片2.5 mg,口服,每日1次;B組患者給予氯沙坦鉀片50 mg,口服,每日1次。兩組療程均為8周。觀察兩組患者的臨床療效,治療前后血壓水平、血糖水平、腎功能指標(血肌酐、血尿酸、血尿素氮、尿微量蛋白)、舒張期左心室厚度及不良反應(yīng)發(fā)生情況。結(jié)果:兩組患者總有效率比較,差異無統(tǒng)計學意義(P0.05)。治療前,兩組患者血壓水平、血糖水平、腎功能指標、舒張期左心室厚度比較,差異均無統(tǒng)計學意義(P0.05)。治療后,兩組患者血壓水平、血糖水平、腎功能指標、舒張期左心室厚度均顯著低于同組治療前,且A組血肌酐、尿微量蛋白顯著低于B組,B組舒張期左心室厚度顯著低于A組,差異均有統(tǒng)計學意義(P0.05),但兩組間血壓水平、血糖水平、血尿酸、血尿素氮比較差異均無統(tǒng)計學意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計學意義(P0.05)。結(jié)論:瑞格列奈聯(lián)合氨氯地平與瑞格列奈聯(lián)合氯沙坦鉀治療T2DM合并原發(fā)性高血壓的療效和安全性均相當,但瑞格列奈聯(lián)合氨氯地平在降低尿微量蛋白水平、改善腎功能方面優(yōu)于瑞格列奈聯(lián)合氯沙坦鉀,瑞格列奈聯(lián)合氯沙坦鉀在延緩左心室重構(gòu)、保護心臟功能方面優(yōu)于瑞格列奈聯(lián)合氨氯地平。
[Abstract]:Aim: to compare the efficacy and safety of repaglinide combined with amlodipine and losartan potassium in the treatment of type 2 diabetes mellitus (T2DM) with essential hypertension. Methods 306 T2DM patients with essential hypertension were randomly divided into group A (153 cases) and group B (153 cases). The patients in both groups were treated with routine diet exercise therapy and insulin therapy. After admission, patients in group A were given levamlodipine benzenesulfonic acid for 2. 5 mg, and repaglinide was given orally for 1 mg, once a day, on the basis of which patients in group A were given levamlodipine benzenesulfonate for 2. 5 mg,. Patients in group B were given losartan potassium tablets once a day for 50 mg,. The course of treatment was 8 weeks in both groups. The clinical efficacy, blood pressure level, blood glucose level, renal function index (serum creatinine, serum uric acid, blood urea nitrogen, urine trace protein), diastolic left ventricular thickness and adverse reaction were observed. Results: there was no significant difference in the total effective rate between the two groups (P0.05). Before treatment, there was no significant difference in blood pressure, blood glucose, renal function and diastolic left ventricular thickness between the two groups (P0.05). After treatment, the blood pressure level, blood glucose level, renal function index, diastolic left ventricular thickness in both groups were significantly lower than those before treatment in the same group, and the serum creatinine in group A was significantly lower than that in the same group. The left ventricular thickness in group B was significantly lower than that in group B (P0.05), but there was no significant difference in blood pressure level, blood glucose level, uric acid and blood urea nitrogen between the two groups (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: the efficacy and safety of repaglinide combined with amlodipine and repaglinide combined with losartan potassium in the treatment of T2DM with essential hypertension are equal, but repaglinide combined with amlodipine can reduce the level of urinary trace protein. The improvement of renal function was superior to that of repaglinide combined with losartan potassium, repaglinide combined with losartan potassium in delaying left ventricular remodeling and protecting heart function than repaglinide combined with amlodipine.
【作者單位】： 重慶醫(yī)科大學附屬第一醫(yī)院第一分院;重慶市第五人民醫(yī)院心內(nèi)科;
【分類號】：R587.1;R544.11

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