度拉糖肽联合氢氯噻嗪对高血压合并糖尿病患者血压与血脂及氧化应激的影响

Effects of dulosacetide combined with hydrochlorothiazide on blood pressure, blood lipid and oxidative stress in hypertensive patients combined with diabetes mellitus

目的 探讨度拉糖肽联合氢氯噻嗪治疗高血压合并糖尿病的临床效果。方法 将2019年8月至2020年7月巴中市中心医院收治的120例高血压合并糖尿病患者按随机数字表法分为2组,每组60例。对照组给予氢氯噻嗪治疗,观察组加用度拉糖肽治疗,比较治疗前后血压、血糖、血脂、微量白蛋白尿、动态动脉硬化指数及氧化应激等变化。结果 治疗后观察组收缩压(SBP)由(175.63±34.12) mmHg(1 mmHg=0.133 kPa)降低至(128.15±25.61) mmHg,低于对照组(139.26±27.39) mmHg(t=2.295,P=0.024);舒张压(DBP)由(112.53±21.78) mmHg降低至(88.23±16.40) mmHg,低于对照组(95.70±18.38) mmHg(t=2.349,P=0.021)。治疗后2组患者的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TG)、三酰甘油(TC)、低密度脂蛋白胆固醇(LDL-C)水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后2组微量白蛋白尿(MAU)、动态动脉硬化指数(AASI)水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后2组硫氧还蛋白(TRX)水平降低(P<0.05),谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平升高(P<0.05),且观察组改善程度优于对照组(P<0.05)。结论 度拉糖肽联合氢氯噻嗪治疗可明显改善高血压合并糖尿病患者血压、血脂等,减轻氧化应激损伤。

Objective To investigate the clinical effect of dulosacetide combined with hydrochlorothiazide in the treatment of hypertension combined with diabetes mellitus.Methods A total of 120 patients with hypertension combined with diabetes admitted to our hospital from August 2019 to July 2020 were divided into 2 groups by random number method, 60 patients in each group.The control group was treated with hydrochlorothiazide, and the observation group was treated with dulosacetide combined with hydrochlorothiazide.The changes of blood pressure, blood glucose, blood lipid, microalbuminuria, dynamic arteriosclerosis index and oxidative stress before and after treatment were compared.Results After treatment, the SBP in the observation group decreased from(175.63±34.12) mmHg to(128.15±25.61) mmHg, which was lower than that in the control group(139.26±27.39) mmHg(t=2.295,P=0.024).DBP decreased from(112.53±21.78) mmHg to(88.23±16.40) mmHg, lower than the control group(95.70±18.38) mmHg(t=2.349,P=0.021).After treatment, FPG,2hPG,HbA1c, TG, TC and LDL-C levels in the two groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).After treatment, the levels of MAU and AASI in both groups were decreased(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).After treatment, the TRX level of the two groups decreased(P<0.05),and the GSH-Px and SOD levels increased(P<0.05),and the improvement degree of the observation group was better than that of the control group(P<0.05).Conclusions Dulosacetide combined with hydrochlorothiazide can significantly improve the blood pressure and blood lipids, and reduce oxidative stress injury in patients with hypertension and diabetes mellitus.