卡托普利联合硝苯地平治疗2型糖尿病合并高血压的临床分析

Clinical analysis of captopril combined with nifedipine in the treatment of type 2 diabetes and hypertension

目的 探讨卡托普利联合硝苯地平治疗2型糖尿病合并高血压的临床效果.方法 将高血压合并2型糖尿病的患者240例完全随机分为卡托普利组、硝苯地平组、联合组,各80例.在3组均给予二甲双胍类及磺脲类药物控制血糖的基础上,卡托普利组口服卡托普利25 mg,3次/d,硝苯地平组患者给予硝苯地平片10 mg,1次/d,联合组患者给予卡托普利25 mg,3次/d,硝苯地平片10 mg,1次/d,2个月为1个疗程,比较3组临床疗效、血糖、肾功能及不良反应.结果 联合组中显效51例,总有效率为92.5％,明显高于卡托普利组的25例,总有效率为76.2％,且高于硝苯地平组的21例,总有效率为68.7％,差异均有统计学意义（Х^2 =27.55,Х^2=14.30,均P＜0.05）,联合组收缩压、舒张压、餐后2h血糖、糖化血红蛋白、血肌酐和血尿素氮与其他2组比较差异有统计学意义（F值分别为5.73、4.56、4.10、3.05、42.35、7.93,P＜0.05）,结论 采用卡托普利联合硝苯地平治疗2型糖尿病合并高血压,疗效稳定.

Objective To evaluate the clinical efficacy of captopril combined with nifedipine in treatment of type 2 diabetes and hypertension.Methods All 240 cases of hypertension complicated with type 2 diabetes were randomly divided into three groups.Metformin and sulfonylurea were used to control blood sugar in 3 groups.Captopril group received captopril 25 mg,3 times/d.nifedipine group received nifedipine 10 mg,2 times/d.Combined group received both drugs with the same dosage in captopril group and nifedipine group.2 months was a course and the clinical efficacy was compared.Results The number of effective cases of combined group was 51 cases; the total effective rate was 92.5 ％,which was significantly higher than that of captopril group and nifedipine group [76.2％ （25 cases）,68.7％ （21 cases）].Systolic blood pressure,diastolic blood pressure,2 h postprandial blood glucose （2 h PBG）,glycated hemoglobin （HbA1 c）,serum creatinine （Scr） and blood urea nitrogen （BUN） in combined group were significantly different compared with other groups（F：5.73,4.56,4.10,3.05,42.35,7.93,P ＜0.05）.Conclusion Captopril combined with nifedipine is effective and safe in the treatment of type 2 diabetes and hypertension.