达格列净联合苯磺酸氨氯地平治疗2型糖尿病合并高血压的临床效果

Clinical effect of dapagliflozin combined with amlodipine besylate in the treatment of type 2 diabetes with hypertension

目的观察达格列净联合苯磺酸氨氯地平治疗2型糖尿病合并高血压的临床效果。方法选取2019年1月—2021年2月梧州市工人医院收治的2型糖尿病合并高血压患者80例,采用随机数字表法分为观察组和对照组,各40例。观察组给予达格列净联合苯磺酸氨氯地平治疗,对照组给予二甲双胍联合苯磺酸氨氯地平治疗,2组均连续治疗12周。比较2组患者治疗前后血糖指标(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血压(收缩压、舒张压)、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、24 h尿蛋白、体质指数、腹围、血尿酸、血糖达标时间、血压达标时间及不良反应。结果治疗12周后,2组患者空腹血糖、餐后2 h血糖、糖化血红蛋白均较治疗前降低,且观察组低于对照组(P<0.01);2组患者收缩压及舒张压均较治疗前降低,且观察组低于对照组(P<0.01);2组患者TG水平均较治疗前降低,且观察组低于对照组(P<0.01);2组患者TC、LDL-C、HDL-C水平与治疗前比较差异均无统计学意义(P>0.05);观察组患者24 h尿蛋白、腰围、体质指数及血尿酸均低于治疗前及对照组(P<0.05);治疗12周后,对照组患者24 h尿蛋白、腰围、体质指数及血尿酸与治疗前比较差异均无统计学意义(P>0.05)。观察组患者血糖及血压达标时间均短于对照组(P<0.01)。2组患者治疗期间均未出现严重低血糖、消化道反应、电解质紊乱、泌尿道感染及低血压等不良反应。结论达格列净联合苯磺酸氨氯地平治疗2型糖尿病合并高血压的效果较好,安全性较高,值得临床推广。

Objective To observe the clinical effect of dapagliflozin combined with amlodipine besylate in the treatment of type 2 diabetes with hypertension.Methods Selected 80 patients with type 2 diabetes and hypertension who were admitted to Gongren Hospital of Wuzhou City from January 2019 to February 2021,using random number table method,they were divided into observation group and control group,each of 40 cases.The observation group was treated with dapagliflozin combined with amlodipine besylate,and the control group was treated with metformin combined with amlodipine besylate,both groups were treated for 12 consecutive weeks.Compared the blood glucose indexes(fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin),blood pressure(systolic blood pressure,diastolic blood pressure),blood lipid indexes[total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],24-hour urine protein,body mass index,abdominal circumference before and after treatment,blood uric acid,blood glucose up to standard time,blood pressure up to standard time and adverse reactions between the two groups.Results After 12 weeks of treatment,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01);The systolic blood pressure and diastolic blood pressure of the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01);The TG levels of the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01);After 12 weeks of treatment,the levels of TC,LDL-C and HDL-C in the two groups were not significantly different from those before treatment(P>0.05);The 24 h urine protein,waist circumference,body mass index and blood uric acid of the observation group were lower than those before treatment and the control group(P<0.05);The observation group’s blood glucose and blood pressure reaching standard time were shorter than those of the control group(P<0.01).During the treatment of the two groups,there were no adverse reactions such as severe hypoglycemia,gastrointestinal reactions,electrolyte disturbances,urinary tract infections and hypotension.Conclusion Dapagliflozin combined with amlodipine besylate has a good effect in the treatment of type 2 diabetes with hypertension,and has high safety,which is worthy of clinical promotion.