乌拉地尔注射液联合替米沙坦治疗高血压伴糖尿病的疗效观察及炎性因子的影响

Curative efficacy of Urapidil injection combined with telmisartan in treatment of hypertension with diabetes mellitus and its effects on serum of sVCAM-1、APN、YKL-40

目的:研究乌拉地尔注射液联合替米沙坦治疗高血压伴糖尿病的疗效观察及对血清血管细胞粘附分子-1(s VCAM-1)、脂联素(APN)、人软骨蛋白-39(YKL-40)的影响。方法:收集2015年3月至2016年3月,我院高血压伴糖尿病患者,按单纯随机分组法分为实验组(n=40)和对照组(n=40)。两组均采用常规治疗,对照组在此基础上,采用乌拉地尔注射液治疗,每次100mg。实验组在对照组的基础上,采用替米沙坦治疗,每次40mg,每天1次。对比两组血压指标舒张压(DBP)、收缩压(SBP)水平,腹胰岛素(FINS)、FBG、Hb Alc水平,s VCAM-1、APN、YKL-40水平,不良反应发生率,治疗疗效。结果:实验组DBP、SBP水平均显著低于对照组[(66.38±7.54)vs.(72.30±8.79)mm Hg,(105.36±7.58)vs.(126.40±8.60)mm Hg(1mm Hg=0.133k Pa,P<0.05];FPG水平均显著低于对照组[(5.87±1.02)vs.(7.32±1.30)mmol/L,P<0.05];血清s VCAM-1、YKL-40水平均显著低于对照组[(712.39±161.03)vs.(852.08±173.02)μg/L,(57.38±6.01)vs.(87.09±8.02)μg/L,P<0.05],APN水平均显著高于对照组[(9.76±2.15)vs.(7.27±1.90)mg/L,P<0.05];两组不良反应发生率无差异[15.00%(6/40)vs.32.50%(13/40),P>0.05];总有效率显著高于对照组[95.00%(38/40)vs.72.50%(29/40),P<0.05]。结论:乌拉地尔注射液联合替米沙坦治疗高血压伴糖尿病的疗效显著,可有效调控患者的血压、糖脂代谢,可显著降低血清s VCAM-1、YKL-40水平,增高APN水平,减少心血管事件的发生率。

Objective： To study curative efficacy of Urapidil injection combined with telmisartan in treatment of hypertension with diabetes mellitus and its effects on serum of s VCAM-1、APN、YKL-40. Methods：80 patients of hypertension with diabetes mellitus who received therapy from March 2015 to March 2016 in our hospital were selected as research objects. According to the draw method divided into control group（ n = 40）and experimental group（ n = 40） Conventional treatment was used in the two groups,the control group was on this basis,treated with Urapidil injection,every time 100 mg. while the experimental group was based on the control group,treated with telmisartan,every time 40 mg,1 times a day. Then blood pressure DBP,SBP,fasting insulin（ FINS）,FBG,Hb Alc,vascular cell adhesion molecule-1（ s VCAM-1）,adiponectin（ APN）,-39（ YKL-40） cartilage protein level,the incidence of adverse reactions,treatment effect of two groups were compared. Results： The levels of DBP and SBP in the experimental group were significantly lower than the control group[（ 66. 38 ± 7. 54） vs.（ 72. 30 ± 8. 79） mm Hg,（ 105. 36 ± 7. 58） vs.（ 126. 40 ± 8. 60） mm Hg,P〈0.05 ];The levels of FPG were significantly lower than the control group[（ 5. 87 ± 1. 02） vs.（ 7. 32 ± 1. 30） mmol/L,P〈0.05]; The levels of serum s VCAM-1,APN and YKL-40 were significantly lower than the control group[（ 712. 39 ± 161. 03） vs.（ 852. 08 ± 173. 02） μg/L,（ 57. 38 ± 6. 01） vs.（ 87. 09 ± 8. 02） μg/L,P〈0.05],The level of APN was significantly higher than that of the control group[（ 13. 76 ± 2. 15） vs.（ 10. 27 ± 1. 90） mg/L,P〈0.05]; There was no difference in the incidence of adverse reactions between the two groups[15. 00%（ 6/40） vs. 32. 50%（ 13/40）,P〈0.05 ]; The total effective rate was significantly higher than the control group[95. 00%（ 38/40） vs. 72. 50%（ 29/40）,P〈0.05]. Conclusion： Urapidil injection combined with telmisartan is effective in the treatment of hypertension and diabetes. It can effectively regulate blood pressure,glucose and lipid metabolism,significantly reduce serum s VCAM-1 and YKL-40 levels,increase APN level,and reduce the incidence of cardiovascular events.