不同剂量厄贝沙坦联合苯磺酸氨氯地平治疗2型糖尿病合并高血压伴微量白蛋白尿的效果观察  

Observation of effect of treatment with different doses of irbesartan and amlodipine besylate in patients with type 2 diabetes accompanied by hypertension and microalbuminuria

作　　者：刘建红 关群 洪小茜 王东 李曼 苏琴[2] 

机构地区：[1]火箭军总医院礼士路门诊部内一科,北京100820 [2]解放军总医院第一附属医院急救部,北京100048

出　　处：《感染．炎症．修复》2015年第4期228-230,共3页Infection Inflammation Repair

基　　金：首都市民健康项目培训(Z141100002114018)

摘　　要：目的:观察不同剂量厄贝沙坦联合苯磺酸氨氯地平对2型糖尿病合并高血压伴微量白蛋白尿患者血压、尿白蛋白/尿肌酐比值(Pro/Ucr E)、血清同型半胱氨酸(Hcy)的影响。方法:我院门诊诊断为2型糖尿病合并高血压伴微量白蛋白尿患者78例,随机分成A组(38例)和B组(40例)。A组给予苯磺酸氨氯地平片5 mg/d+厄贝沙坦片150 mg/d。B组给予苯磺酸氨氯地平片5 mg/d厄贝沙坦片300 mg/d。疗程3个月。观察治疗后两组患者24 h平均收缩压(MSBP/24 h)、舒张压(MDBP/24 h)、Pro/Ucr E、血清Hcy的变化。结果:治疗3个月后与治疗前比较,两组患者各项指标均有显著改善(P均<0.05)。治疗3个月后两组患者之间比较,MSBP/24h、MDBP/24h差异无统计学意义(P>0.05);但与A组比较,B组患者Pro/Ucr E及血中Hcy表达显著降低(P均<0.05)。结论:300 mg厄贝沙坦片联合苯磺酸氨氯地平片可显著改善2型糖尿病合并高血压伴微量白蛋白尿患者血压、Pro/Ucr E及血清Hcy水平,且与150 mg厄贝沙坦片联合苯磺酸氨氯地平片比较,其改善Pro/Ucr E、血清Hcy的效果更为显著。Objective： To observe the effects of different doses of irbesartan combined with amlodipine besylate on blood pressure, urinary albumin/urine creatinine ratio（Pro/Ucr E）, and serum homocysteine（Hcy） contents in patients with type 2 diabetes accompanied by hypertension and microalbuminuria. Methods： In the General Hospital of PLA Rocket Force, 78 out-patients who were diagnosed as type 2 diabetes accompanied by hypertension and microalbuminuria were randomly divided into two groups： 38 patients in group A, to whom amlodipine besylate tablets 5 mg per day and irbesartan tablets 150 mg per day were given orally, and 40 patients in group B received amlodipine besylate tablets 5 mg and irbesartan tablets 300 mg/d orally. All the patients received the treatment for 3 months. The changes in mean systolic blood pressure in 24 hours（MSBP/24 h）, mean diastolic blood pressure in 24 hours（MDBP/24 h）, Pro/Ucr E, and serum Hcy content were observed before and after treatment in both groups. Results： It was found that 3-month treatment could lower blood pressure, Pro/Ucr E and serum Hcy content were lower significantly in group B（P〈0.05）. There was no significant difference in MSBP/24 h and MDBP/24 h between two groups after 3 months of treatment（P0.05）. However, the levels of Pro/Ucr E and serum Hcy content in group B were lower significantly compared with those of group A（P〈0.05）. Conclusions： In patients with type 2 diabetes accompanying hypertension and microalbuminuria, blood pressure, Pro/Ucr E and serum Hcy level can be improved by combined use of 300 mg irbesartan and amlodipine besylate, and the effects were better than the combined administration of 150 mg irbesartan and amlodipine besylate.

关 键 词：厄贝沙坦 2型糖尿病 高血压 微量蛋白尿 同型半胱氨酸 

分 类 号：R255.4[医药卫生—中医内科学]