2型糖尿病伴高血压的联合降压方案的疗效评价

【摘要】 目的通过动态血压监测探讨不同类型的降压药组合对糖尿病伴高血压患者的血压的影响,为合理选择降压药物提供依据。方法将2型糖尿病伴高血压患者40例随机分为两组,一组(20例)用依那普利+氨氯地平治疗,另一组(20例)用依那普利+钠催离治疗,两组均治疗4周,观察动态血压参数。结果两组药物治疗第4周末24h动态血压发现,24h平均收缩压、舒张压、脉压均较服药前明显降低,统计学上有显著性差异,依那普利+氨氯地平组24h平均收缩压下降了25.5mmHg,24h平均舒张压下降了16.4mmHg;依那普利+钠催离组24h平均收缩压下降了17.2mmHg,24h平均舒张压下降了11.5mmHg。依那普利+氨氯地平组24h脉压下降幅度为11.1mmHg和依那普利+钠催离组24h脉压下降幅度为5.7mmHg,依那普利+氨氯地平组优于依那普利+钠催离组,经检验有统计学差异(p<0.001);依那普利+氨氯地平组和依那普利+钠催离组降压达标率分别为60%和50%。结论对2型糖尿病伴高血压患者早期联合使用2种降压药物,可尽快达到<130/80mmHg的目标血压。依那普利+氨氯地平组降压幅度优于依那普利+钠催离组。更多还原

【Abstract】 Objectives: The aim of the study was to evaluate the effects of the varying combine using 2 anti-hypertensive drugs to the hypertension patients with diabetes by ambulatory blood pressure monitoring (ABPM). METHODS: The study was made in 40 hypertension patients with diabetes in the Department of Cardiology. Of these, 20 were treated by enalapril combine amlodipine, another 20 were treated by enalapril combine natrilix for 4 weeks. The ABPM were performed in all patients at the beginning of treatment and the end of 4 weeks treatment. RESULTS: The ABPM parameters were significant decrease in two groups at the end of 4 weeks treatment. The 24 h mean systolic and diastolic blood pressure were decreased 25.5mmHg and 16.4mmHg in the enalapril combine amlodipine group. The 24 h mean systolic and diastolic blood pressure were decreased 17.2mmHg and 11.5mmHg in the enalapril combine natrilix group. There were significant difference(p<0.001) in 24 h pulse pressure in enalapril combine amlodipine group and enalapril combine natrilix group(11.1mmHg vs 5.7mmHg).The rate of achieve goal BP were 60% vs 50% in enalapril combine amlodipine group and enalapril combine natrilix group. Conclusion: To achieve goal BP (<130/80 mm Hg), we should early use two antihypertensive medications in hypertension patients with diabetes. The effect of decrease blood pressure were better in enalapril combine amlodipine than in enalapril combine natrilix .更多还原