缬沙坦对原发性高血压伴糖尿病性视网膜病变的治疗作用

Therapeutical effect of valsartan on essential hypertension with diabetic retinopathy

目的探讨缬沙坦对原发性高血压糖尿病性视网膜病变的治疗作用。方法选择原发性高血压伴2型糖尿病合并Ⅱ～Ⅲ期糖尿病性视网膜病变35例，随机分为缬沙坦治疗组17例和对照组18例，分别口服缬沙坦和其他降压药物治疗，于服药前和服药后2个月及12个月时测定收缩压、舒张压、空腹血糖、餐后2h血糖和散瞳眼底检查及眼底荧光造影结果。结果缬沙坦组治疗2个月、12个月时收缩压、舒张压、空腹血糖、餐后2h血糖均较治疗前明显下降，差异有显著性（P〈0．01）；与对照组同期相比降压及降糖效果明显（P〈0．05）；且眼底病变进展缓慢（P〈0．05）。结论缬沙坦在降低血压的同时确有改善糖代谢、延缓糖尿病性视网膜病变发展的作用，可用于高血压合并2型糖尿病治疗。

Objective To observe the therapeutical effect of valsartan on essential hypertension with diabetic retinopathy. Methods The patients with essential hypertension complicated with type 2 diabetes and diabetic retinopathywere randomly divided into valsartan group （valsartan, n = 17） and control group （conventional hypotensive drug, n = 18）. The changes of blood pressure,blood glucose,examination of ocular fundus of mydriasis and fluorescein fundus angiographywere observed before and after 2,12 months of treatment. Results After 2, 12 months of treatment by Valsartan, the blood pressure, blood glucosewere decreased significantly, compared with those before treatment （ P 〈 0.01 ） and the corresponding period in control group （ P 〈 0.05）. Progression of pathological changes of eyeground was slower in valsartan group than those in Control group （ P 〈 0.05 ）. Conclusion Valsartan can lower the blood pressure, improve glycometabelism, and delay the development of diabetic retinopathy, it can be used in the treatment of essential hypertension complicated with type 2 diabetes.