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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。
Objective To investigate the effects of different types of antihypertensive combination on blood pressure in patients with diabetes mellitus by ambulatory blood pressure monitoring, so as to provide a basis for rational selection of antihypertensive drugs. Methods Forty patients with type 2 diabetes mellitus and hypertension were randomly divided into two groups. One group (20 cases) was treated with enalapril and amlodipine. The other group (20 cases) was enalapril + sodium After treatment, the two groups were treated for 4 weeks, and the dynamic blood pressure parameters were observed. Results 24h ambulatory blood pressure at the end of the fourth week of the two groups of drugs found that 24h mean systolic blood pressure, diastolic blood pressure and pulse pressure were significantly lower than before medication, statistically significant difference, enalapril + amlodipine 24h average contraction The mean diastolic pressure dropped by 16.4mmHg in 24 hours. The average systolic blood pressure decreased by 17.2mmHg in 24h after enalapril + sodium dissociation, while the average diastolic blood pressure decreased by 11.5mmHg in 24h. Enalapril + amlodipine group 24h pulse pressure decreased by 11.1mmHg and enalapril + sodium excretion 24h pulse pressure decreased by 5.7mmHg, enalapril + amlodipine group was better than that of enalapril (+0.01). The compliance rates of enalapril + amlodipine group and enalapril + sodium apheresis group were 60% and 50%, respectively. Conclusions Early use of two antihypertensive drugs in patients with type 2 diabetes mellitus and hypertension can achieve target blood pressure <130 / 80mmHg as soon as possible. Enalapril + amlodipine group was better than enalapril + sodium in the group.