氯沙坦联合氨氯地平治疗老年高血压合并糖尿病的疗效观察

Efficacy of losartan combined with amlodipine in treatment of elderly patients with hypertension and diabetes

目的对氯沙坦、氨氯地平二者联用治疗老年高血压合并糖尿病的临床疗效进行观察。方法对2014年1月~2015年1月来我院治疗的老年高血压合并糖尿病患者80例作为研究对象,随机分为两组,观察组应用氯沙坦、氨氯地平治疗,对照组应用氯沙坦治疗,疗程3个月。治疗前后分别监测两组患者的血压（SBP、DBP）、血糖（空腹血糖、餐后2 h血糖）及肾功能指标血尿素氮（BUN）、血肌酐（Scr）、尿微量白蛋白水平,同时观察并记录期间发生的药物不良反应。结果治疗3个疗程后,观察组与对照组的总有效率分别为95.0%、77.5%,两组疗效组间比较,差异存在显著的统计学意义（P〈0.05）。观察组患者治疗后的BUN、Scr、UAER水平分别较治疗前及对照组显著降低,组间比较,差异存在显著的统计学意义（P〈0.05）。观察组患者治疗后的收缩压、舒张压水平及空腹血糖、餐后2 h血糖水平分别较治疗前及对照组显著降低,组间比较,差异存在显著性（P〈0.05）。结论氯沙坦、氨氯地平二者联用治疗老年高血压合并糖尿病的临床疗效显著提高,血压和血糖水平得到显著控制,且对肾功能具有保护作用。

Objective To observe the clinical effect of losartan and amlodipine in treatment of elderly patients with hypertension and diabetes mellitus. Methods 80 cases elderly hypertensive patients complicated with diabetes mellitus treated in our hospital were selected from January 2014 to January 2015 as the object of study, and were randomly as- signed to two groups, the observation group was treated with losartan, amlodipine, losartan treatment,control group was treated with losartan. The treatment course was three months. Before and after treatment, blood pressure （SBP, DBP）, blood glucose（fasting blood glucose, postprandial 2 hours blood glucose）, and index of renal function, blood urea ni- trogen（BUN）, serum creatinine（SCR）, urinary albumin level were observed and recorded between two groups,and observed and recorded the adverse drug reaction. Results After 3 courses of treatment, the total effective rate of the observation group and the control group were 95.0% and 77.5% respectively. There was significant difference between the two groups（P〈0.05）. The BUN, Scr, UAER levels in the observation group were significantly lower than those be- fore treatment and the control group, the difference was significant（P〈0.05）. After treatment,the systolic blood pressure, diastolic blood pressure and fasting blood glucose, postprandial 2 hours of blood glucose levels were significantly lower than before treatment and control group, there were significant differences between two groups（P〈0.05）. Conclusion The combination of losartan and amlodipine in the treatment of elderly patients with hypertension and diabetes melli- tus can significantly improve the clinical efficacy, blood pressure and blood glucose levels are significantly controlled, and renal function has a protective effect.