依那普利联合厄贝沙坦对糖尿病合并高血压患者的有效性及对血管内皮功能的影响

The Efficacy of Enalapril Combined with Irbesartan in Diabetic Patients with Hypertension and Its Effects on Vascular Endothelial Function

目的:观察分析依那普利联合厄贝沙坦治疗对糖尿病合并高血压患者的有效性及对患者血管内皮功能的影响。方法:回顾性分析2017年6月至2019年7月间我院收治的142例糖尿病合并高血压患者的临床资料,依据治疗措施的不同进行分组,其中71例接受依那普利联合厄贝沙坦治疗者作治疗组,71例接受厄贝沙坦治疗者作对照组,比较两组患者血糖指标、血压及血管内皮功能指标的水平,记录两组患者的不良反应发生情况。结果:治疗后,治疗组患者的餐后2 h血糖(2hPBG)、空腹血糖(FPG)及糖化血红蛋白(HbA1c)水平均比对照组更低(P<0.05)。治疗组患者治疗后的收缩压(SBP)为(123.28±5.34)mmHg,舒张压(DBP)为(81.32±3.19)mmHg,分别低于对照组的(132.47±6.46)mmHg与(92.83±4.58)mmHg(P<0.05)。治疗后,治疗组患者的血管内皮功能指标血管内皮生长因子(VEGF)、一氧化氮(NO)水平及NO/ET-1比值均高于对照组(P<0.05),内皮素-1(ET-1)水平低于对照组(P<0.05)。治疗期间,治疗组患者不良反应的发生率(8.45%)高于对照组患者(5.63%),但差异无统计学意义(P>0.05)。结论:依那普利联合厄贝沙坦治疗2型糖尿病(T2DM)合并原发性高血压患者能有效促进NO与ET-1浓度的平衡,增加VEGF、NO/ET-1比值的表达,对改善血管内皮细胞功能,维持血管舒缩功能平衡有积极意义,同时联合用药治疗不会增加不良反应发生率,安全性较好。

Objective:To observe and analyze the efficacy of enalapril combined with irbesartan in diabetes patients with hypertension and its effects on vascular endothelial function.Methods:The clinical data of 142 cases of diabetic patients with hypertension admitted in our hospital from June 2017 to July 2019 were retrospectivly analized.According to different treatment measures,71 patients received enalapril combined with irbesartan treatment were set as the treatment group,and 71 patients received irbesartan treatment were set as the control group.The levels of blood glucose indexes,blood pressure and vascular endothelial function indicators were compared between the two groups of patients before and after treatment.At the same time,the occurrence of adverse reactions in both groups was recorded.Results:After treatment,the levels of 2hPBG,FPG and HbA1c of patients in the treatment group were lower than those in the control group(P<0.05).After treatment,the SBP of patients in the treatment group was(123.28±5.34)mmHg,and the DBP was(81.32±3.19)mmHg,which were lower than(132.47±6.46)mmHg and(92.83±4.58)mmHg in the control group(P<0.05).After treatment,the levels of vascular endothelial function indicators VEGF,NO and NO/ET-1 of patients in the treatment group were higher than those in the control group(P<0.05),and the levels of ET-1 was lower than that in the control group(P<0.05).The incidence of adverse reactions during treatment in the treatment group(8.45%)was higher than that in the control group(5.63%),but the difference was not statistically significant(P>0.05).Conclusion:Enalapril combined with irbesartan in the treatment of T2DM patients with essential hypertension can effectively promote the balance of NO and ET-1 concentration,increase the expression of VEGF,NO/ET-1 ratio,improve the function of vascular endothelial cells,maintain the balance of vasomotor function,and the combined treatment does not increase the incidence of adverse reactions and has good safety.