贝那普利联合氨氯地平治疗老年2型糖尿病合并高血压的疗效及安全性

Clinical effects and safety of benazepril combined with amlodipine on elderly patients with type 2 diabetes mellitus complicated by hypertension

目的 探讨贝那普利联合氨氯地平治疗老年2型糖尿病合并高血压的疗效及其安全性.方法 采用随机数字表法将南通市第三人民医院2016年1月至2018年1月收治的80例老年（≥60岁）2型糖尿病患者分为A、B、C三组.所有患者均接受常规降糖等基础治疗,A组给予盐酸贝那普利片10 mg口服,B组给予苯磺酸左旋氨氯地平片5 mg口服,C组给予联合用药,均为1次/d.比较三组治疗效果及治疗前后血糖、血压、肾功能指标、血沉、C反应蛋白（CRP）水平的变化.结果 干预后三组血糖指标与同组干预前比较差异均未见统计学意义（P均〉0.05）.干预前三组肾功能指标比较差异未见统计学意义（P〉0.05）,干预后C组尿微量白蛋白、收缩压、舒张压低于A、B组,肾小球滤过率（eGFR）高于A、B组,差异有统计学意义（P〈0.05）.干预前三组血沉及CRP水平比较差异均未见统计学意义（P均〉0.05）,干预后C组血沉、CRP水平低于A、B组,差异有统计学意义（P〈0.05）.结论 对于老年2型糖尿病合并高血压患者,贝那普利联合氨氯地平能够显著降低血压、改善肾功能,疗效确切,值得临床推广.

Objective To investigate the clinical effects and safety of benazepril combined with amlodipine on elderly patients with type 2 diabetes mellitus complicated by hypertension. Methods Eighty elderly patients （over 60 year-old） with type 2 diabetes mellitus and treated in the Third People＇s Hospital of Nantong from January 2016 to January 2018 were divided into group A, group B and group C by random number table method. All patients received basic treatment, like routine hypoglycemic protection; patients in group A were given benazepril hydrochloride tablets, 10 mg, orally; and patients in group B were given levamlodipine besylate tablets, 5 mg, orally, 1 time/d; while patients in group C were given the combination of drugs, 1 time/d. Then, the treatment effects, blood sugar before and after treatment, blood pressure, renal function index, levels of blood sedimentation and CRP of three groups before and after treatment were compared. Results There was no significant difference in the blood sugar level before and after intervention cross the three groups （ P 〉 0. 05 ）. There was no significant difference in renal function indexes among the three groups before intervention （ P 〉 0. 05 ）. After intervention, the urine microalbumin, systolic blood pressure and diastolic blood pressure in group C were lower than those in group A and group B, the glomerular filtration rate （eGFR） was higher than that in group A and group B, the difference was statistically significant （P 〈 0. 05 ）. There was no significant difference in the level of blood sedimentation and CRP among the three groups before intervention （ P 〉 0. 05 ）. After intervention, the blood sedimentation and CRP in group C were lower than those in group A and group B, and the difference was statistically significant （P 〈 0. 05）. Conclusions For the elderly patients with type 2 diabetes mellitus complicated by hypertension, the benazepril combined with amlodipine can significantly reduce blood pressure and improve renal function, of which the clinical effect is accurate, thus it is worth promoting.