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
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篇名: 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
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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(P>0.05)。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(P>0.05)。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(P<0.05),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(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。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: OBJECTIVE: To compare the efficacy and safety of repaglinide respectively combined with amlodipine and losartan potassium in the treatment of diabetes mellitus type 2(T2DM) complicated with primary hypertension. METHODS: 306 T2DM patients complicated with primary hypertension were randomly divided into group A (153 cases) and group B (153 cases). All patients received conventional diet exercise and insulin, then orally given Repaglinide tablet 1 mg after admission, once a day; based on it, group A was orally given Levamlodipine besylate tablet 2.5 mg, once a day; group B was orally given Losartan potassium tablet 50 mg, once a day. All patients were treated for 8 weeks. Clinical efficacy, blood pressure level, blood glucose level, renal function (blood creatinine, blood uric acid, blood urea nitrogen, urine microprotein), diastolic left ventricular thickness before and after treatment, and the incidence of adverse reactions in 2 groups were observed. RESULTS: There was no significant difference in the total effective rate in 2 groups (P>0.05). Before treatment, there were no significant differences in blood pressure level, blood glucose level, renal function indexes and diastolic left ventricular thickness (P>0.05). After treatment, blood pressure level, blood glucose level, renal function indexes and diastolic left ventricular thickness in 2 groups were significantly lower than before, blood creatinine and urine microprotein in groups A were lower than group B, diastolic left ventricular thickness in group B was lower than group A, with statistical significances (P<0.05), while no significant differences in blood pressure level, blood glucose level, blood uric acid and blood urea nitrogen in 2 groups (P>0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS: Repaglinide combined with amlodipine shows similar efficacy and safety with repaglinide combined with losartan potassium in the treatment of T2DM complicated with primary hypertension, while repaglinide combined with amlodipine is superior to repaglinide combined with losartan potassium in terms of reducing urine microprotein level and improving renal functions, and repaglinide combined with losartan potassium is superior to repaglinide combined with amlodipine in terms of delaying left ventricular remodeling and protect the cardiac functions.
期刊: 2017年第28卷第3期
作者: 徐丹,黄龙贤,周大燕,屈宗杰
AUTHORS: XU Dan,HUANG Longxian,ZHOU Dayan,QU Zongjie
关键字: 瑞格列奈;氨氯地平;氯沙坦钾;2型糖尿病;原发性高血压;疗效;安全性
KEYWORDS: Repaglinide; Amlodipine; Losartan potassium; Diabetes mellitus type 2; Primary hypertension; Efficacy; Safety
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