瑞格列奈分别联合氨氯地平、氯沙坦钾治疗T2DM合并原发性高血压的疗效和安全性比较

发布时间：2018-09-05 14:24

【摘要】：目的:比较瑞格列奈分别联合氨氯地平、氯沙坦钾治疗2型糖尿病(T2DM)合并原发性高血压的疗效和安全性。方法:306例T2DM合并原发性高血压患者随机分为A组(153例)和B组(153例)。两组患者均采用常规饮食运动疗法及胰岛素治疗,入院后给予瑞格列奈片1 mg,口服,每日1次;在此基础上,A组患者给予苯磺酸左旋氨氯地平片2.5 mg,口服,每日1次;B组患者给予氯沙坦钾片50 mg,口服,每日1次。两组疗程均为8周。观察两组患者的临床疗效,治疗前后血压水平、血糖水平、肾功能指标(血肌酐、血尿酸、血尿素氮、尿微量蛋白)、舒张期左心室厚度及不良反应发生情况。结果:两组患者总有效率比较,差异无统计学意义(P0.05)。治疗前,两组患者血压水平、血糖水平、肾功能指标、舒张期左心室厚度比较,差异均无统计学意义(P0.05)。治疗后,两组患者血压水平、血糖水平、肾功能指标、舒张期左心室厚度均显著低于同组治疗前,且A组血肌酐、尿微量蛋白显著低于B组,B组舒张期左心室厚度显著低于A组,差异均有统计学意义(P0.05),但两组间血压水平、血糖水平、血尿酸、血尿素氮比较差异均无统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:瑞格列奈联合氨氯地平与瑞格列奈联合氯沙坦钾治疗T2DM合并原发性高血压的疗效和安全性均相当,但瑞格列奈联合氨氯地平在降低尿微量蛋白水平、改善肾功能方面优于瑞格列奈联合氯沙坦钾,瑞格列奈联合氯沙坦钾在延缓左心室重构、保护心脏功能方面优于瑞格列奈联合氨氯地平。
[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.
【作者单位】：重庆医科大学附属第一医院第一分院;重庆市第五人民医院心内科;
【分类号】：R587.1;R544.11

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