达格列净联合福辛普利治疗高血压合并糖尿病的效果分析

Effect of dapagliflozin combined with fosinopril on treatment of hypertension and diabetes

目的探析应用联合策略(达格列净+福辛普利)治疗高血压伴糖尿病患者,对其降压、降糖及控制心力衰竭发生风险的影响。方法选择某院2020年11月—2021年8月就诊的120例高血压合并糖尿病患者,采用随机数字表法分为观察组和对照组,每组60例。对照组给予单一福辛普利治疗,观察组给予达格列净联合福辛普利治疗,连续治疗2个月。对比2组患者血压控制指标[24 h收缩压(SBP)、舒张压(DBP)]、血糖控制指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]、心室重构相关参数[右心室的收缩末期容积(RVESV)、舒张末期容积(RVEDV)、左心室重构指数(LVRI)]、心力衰竭发生率。结果治疗前,2组各指标差异均无统计学意义(P>0.05);治疗后观察组FBG、HbA1c分别为(7.11±1.47)mmol/L、(7.22±1.52)%,低于对照组的(7.93±2.05)mmol/L、(8.14±1.67)%(t=2.518、3.156,P<0.05);治疗后观察组24 h SBP、24 h DBP分别为(126.35±5.41)mm Hg、(75.49±4.37)mm Hg,低于对照组的(130.03±5.56)mm Hg、(84.29±5.18)mm Hg(t=3.674、10.058,P<0.05)。观察组和对照组心力衰竭发生率分别为0.00%、3.33%、不良反应率发生率分别为6.67%、5.00%(P均>0.05)。结论联合策略(达格列净+福辛普利)治疗高血压伴糖尿病的临床效果显著,能够控制心力衰竭发生风险,有效地降糖、降压。

Objective To investigate the effects of the combination strategy(dapagliflozin+fosinopril)in the treatment of hypertensive patients with diabetes,on its antihypertensive,hypoglycemic,and control of the risk of heart failure.Methods A total of 120 patients with hypertension and diabetes mellitus who visited a hospital from November 2020 to August 2021 were selected and divided into 60 cases in the observation group and control group respectively by the random number table method.The control group was treated with single fosinopril,and the observation group was treated with dapagliflozin plus fosinopril for 2 months.The blood pressure control indexes[24 h systolic blood pressure(SBP),diastolic blood pressure(DBP)],glycemic control indexes[fasting blood glucose(FBG),glycated hemoglobin(HbA1c)],ventricular remodeling related parameters[right ventricular end-systolic volume(RVESV),right ventricular end-diastolic volume(RVEDV),left ventricular remodeling index(LVRI)],and heart failure incidence rates were compared between the two groups.Results Before treatment,there was no significant difference between the two groups(P>0.05).The FBG and HbA1c in the posttreatment observation group were(7.11±1.47)mmol/L and(7.22±1.52)%,respectively,which were lower than those in the control group:(7.93±2.05)mmol/L and(8.14±1.67)%,respectively(t=2.518,3.156,P<0.05).After treatment,the 24 h SBP and 24 h DBP in the observation group were(126.35±5.41)mmHg and(75.49±4.37)mmHg,respectively,which were lower than those in the control group:(130.03±5.56)mmHg and(84.29±5.18)mmHg,respectively(t=3.674,10.058,P<0.05).The incidence rates of heart failure in the observation group and the control group were 0.00%and 3.33%,respectively,and the incidence rates of adverse reactions in the observation group and the control group were 6.67%and 5.00%,respectively(both P>0.05).Conclusion The combined strategy(dapagliflozin+fosinopril)has a significant clinical effect in the treatment of hypertension with diabetes,which can control the risk of heart failure,and effectively lower blood sugar and blood pressure.