硫氮酮缓释剂与苯那普利联合治疗2型糖尿病高血压的临床观察  

Antihypertensive effects of diltiazem ER with benazepril in type 2 diabetes with hypertension

作　　者：李永洪[1] 石玫[1] 李莉[1] 杨杰书[1] 袁萍[1] 李雪梅[1] 

机构地区：[1]青岛医学院二附院心内科,山东青岛266042

出　　处：《中国心血管杂志》2004年第2期113-116,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　了解硫氮酮缓释剂与苯那普利联合治疗 2型糖尿病轻中度高血压的疗效 ;每日 1次服药对 2 4 h动态血压 ( ABPM)和心率变异性 ( HRV)的影响 ;并与吲哒帕胺的疗效进行比较。方法　 6 0例轻、中度 2型糖尿病高血压患者被随机分为两组 ,一组每日 1次口服硫氮酮缓释剂 90～ 180 mg+苯那普利 10 mg;另一组每日口服吲哒帕胺 2 .5～ 5 .0 m g+苯那普利 10 m g ,均治疗三个月 ,并于服药前及用药三个月末分别用 2 4 h ABPM和 Holter监测用药前后 ABPM和谷 /峰比值 ( T/ P)、HRV的变化情况。结果　硫氮酮缓释剂组降低收缩压 2 7.8m m Hg( P<0 .0 0 1) ,舒张压 18.5 mm Hg( P<0 .0 0 1) ,T/ P比值分别为 0 .6 4 ,总有效率 89.3%。平均降低偶测心率每分钟 5次( P=NS)。用药前后 HRV比较 :1全部正常窦性心搏间期的标准差 ( SDNN)增加 15 .2 ms( P<0 .0 1) ,2相邻 R- R间期差的均方根值 ( rm SSD)增加 7.84 m s( P<0 .0 1) ,3NN5 0除以总的 NN间期个数 ( p NN5 0 )增加 6 .12 ( P<0 .0 0 1)。吲哒帕胺组降低收缩压 2 5 .9mm Hg( P<0 .0 0 1) ,舒张压 16 .9mm Hg( P<0 .0 0 1) ,T/ P比值分别为 0 .6 6 ,总有效率 85 .7%。但对偶测心率无影响 ,用药前后比较 SDNN增加 2 .8ms( P>0 .0 5 ) ,rm SSD增加 2 .0 3mObjective To compare the antihypertensive effect of diltiazem ER and indapannide both with benazepril, and evaluate the influence of both drugs once daily dosing on heart rate variability(HRV). Methods Eighty type 2 diabetes patients with mild to moderate hypertension were randomized to two groups. One group was treated with diltiazem ER 90~180 mg and the other group with indapannide 2.5~5.0mg once daily dosing, and in both groups, benazepril 10mg/day was added, for 90 days. Both groups were studied by 24-hour ambulatory blood pressure(ABP) and electrocardiograph(AECG) before and after drug holiday. And HR,dSBP,dDBP,nSBP,nDBP,MBP,T/P and HRV were analysed. Results Systolic and diastolic blood pressure was respectively reduced by 27.8mmHg(P<0.001)and 18.5mmHg(P<0.001)in the diltiazem ER group and by 25.9(P<0.001)mmHg and 16.9mmHg(P<0.001)in the indapannide group after treated. But there were no difference in reduction level between two groups(P=NS). Efficacy was respectively achieved in 89.3%of patients in the diltiazem ER group and in 85.7% in the indapannide group(between two groups,P=NS). The average HR was reduced by 5 times per minute in the diltiazem ER group, whereas no changed in the indapannide group(between two groups,P=NS). There were no differences in T/P ratio between two groups(P=NS). All the measured components of HRV, i.e.. SDNN, rmSSD and pNN50 were significantly improved in diltiazem ER group compared with indapannide group(All P> 0.001). Conclusion Diltiazem ER with benazepril was effective and reliable in the treatment of mild and moderate type 2 diabetes hypertension. Abnormal HRV was much better controlled in the diltiazem ER group, compared with that in the indapannide group. But there were no any difference in T/P ratio between two groups.

关 键 词：硫氮Zhuo酮缓释剂 高血压 2型糖尿病 动态血压 心率变异性 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]