度拉糖肽对糖尿病合并轻度单纯夜间高血压患者的血压和EMPs的影响

Effect of dulaglutide on blood pressure and endothelial microparticles in patients with diabetes complicating mild simple nocturnal hypertension

目的研究度拉糖肽对糖尿病合并轻度单纯夜间高血压患者的血压和血浆内皮微粒(EMPs)的影响。方法选取2021年1-12月在江阴市中医院及江苏省苏北人民医院门诊治疗的80例糖尿病合并轻度单纯夜间高血压患者作为研究对象。将受试者分为两组,每组各40例,度拉糖肽组皮下注射度拉糖肽(0.75 mg/周),奥美沙坦组口服奥美沙坦酯(20 mg/d)。评价两组患者治疗前后血压情况、血浆EMPs水平;随访8周,观察两组不良反应发生情况。结果奥美沙坦组治疗后白天、夜间血压均明显下降(P<0.05);度拉糖肽组夜间血压明显下降(P<0.05),白天血压亦下降但差异无统计学意义(P>0.05)。治疗后,两组患者夜间血压控制均达标,夜间血压达标比例差异无统计学意义(奥美沙坦组90.0%vs.度拉糖肽组82.5%,P>0.05);奥美沙坦组夜间血压下降幅度更大(P<0.05)。治疗后,两组患者高血压类型有明显变化,其中勺型高血压比例均明显升高(P<0.05)。两组患者治疗后血浆EMPs水平均明显下降,且奥美沙坦组下降幅度更大,差异均有统计学意义(P<0.05)。两组患者均未出现明显不良反应。结论度拉糖肽能明显降低糖尿病合并轻度单纯高血压患者的夜间血压,并能减少血浆EMPs水平。

Objective To investigate the effect of dulaglutide on the blood pressure and plasma endothelial microparticles(EMPs)level in the patients with diabetes complicating mild simple nocturnal hypertension.Methods Eighty patients with diabetes complicating mild simple nocturnal hypertension treated in the outpatients department of Jiangyin Municipal Hospital of Traditional Chinese Medicine and North Jiangsu People’s Hospital were treated in Jiangyin TCM Hospital and North Jiangsu People’s Hospital from January 2021 to December 2021 were selected as the study subjects and randomly divided into the two groups,40 cases in each group.The dulaglutide group was subcutaneously injected by dulaglutide(0.75 mg/week)and the olmesartan group orally took olmesartan medoximil(20 mg/d).The blood pressure situation and plasma EMPs level before and after treatment were evaluated in the two groups.The follow up lasted for 8 weeks.The occurrence situation of adverse reactions was observed in the two groups.Results The nocturnal blood pressure and daytime blood pressure after treatment in the olmesartan group were decreased significantly(P<0.05),the nocturnal blood pressure in the dulaglutide group was significantly decreased(P<0.05),the daytime blood pressure was also decreased,but the difference was not statistically significant(P>0.05).The nocturnal blood pressure control after treatment reached the standard in both groups,the proportion of nocturnal blood pressure reaching standard had no statistical difference between the two groups(90.0%vs.82.5%,P>0.05).The range of nocturnal blood pressure decrease in the olmesartan was greater(P<0.05).The hypertension type after treatment in the two groups had obvious change,in which the proportion of spoon type hypertension was increased significantly(P<0.05),the plasma EMPs level after treatment in the two groups was significantly decreased,moreover the decrease range in the olmesartan group was greater,and the differences were statistically significant(P<0.05).No significant adverse reactions occurred in both groups.Conclusion Dulaglutide could significantly reduce the nocturnal blood pressure in the patients with diabetes complicating mild simple nocturnal hypertension,moreover could decrease the plasma EMPs levely.