酒石酸美托洛尔片联合瑞舒伐他汀对高血压合并2型糖尿病患者血压变异性及糖脂代谢的影响

Effects of Metoprolol Tartrate Tablets Combined with Rosuvastatin on Blood Pressure Variability and Glucose and Lipid Metabolism in Patients with Hypertension and Type 2 Diabetes Mellitus

目的观察酒石酸美托洛尔片联合瑞舒伐他汀对高血压合并2型糖尿病(T2DM)患者血压变异性(BPV)及糖脂代谢的影响。方法选取2018年1月至2021年1月空军第九八六医院收治的108例高血压合并T2DM患者为研究对象,根据使用的药物不同分为单药组和联合组,每组54例。单药组给予酒石酸美托洛尔片(每次25 mg,每日3次)治疗,联合组给予酒石酸美托洛尔片(方法同单药组)联合瑞舒伐他汀(每次10 mg,每日1次)治疗,两组均连续用药8周。比较两组治疗前后血压[包括日间收缩压(dSBP)、日间舒张压(dDBP)、夜间收缩压(nSBP)、夜间舒张压(nDBP)、24 h收缩压(24 h SBP)、24 h舒张压(24 h DBP)]、BPV参数[包括日间收缩压标准差(dSSD)、日间舒张压标准差(dDSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)、24 h收缩压标准差(24 h SSD)、24 h舒张压标准差(24 h DSD)]、血脂[包括三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血糖[包括空腹血糖(FBG)、餐后2 h血糖(2 h PG)]以及两组不良反应发生情况。结果治疗前后血压(dSBP、dDBP、nSBP、nDBP、24 h SBP、24 h DBP)、BPV参数(dSSD、dDSD、nSSD、nDSD、24 h SSD、24 h DSD)、血脂(TG、TC、LDL-C、HDL-C)、血糖(FBG、2 h PG)的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间血压、BPV参数、血脂、血糖的主效应差异有统计学意义(P<0.05或P<0.01);血压、BPV参数、血脂、血糖的时点间与组间存在交互作用(P<0.05),治疗后血压(dSBP、dDBP、nSBP、nDBP、24 h SBP、24 h DBP)、BPV参数(dSSD、dDSD、nSSD、nDSD、24 h SSD、24 h DSD)、TG、TC、LDL-C、血糖(FBG、2 h PG)水平均低于治疗前(P<0.05),而HDL-C水平均高于治疗前(P<0.05),但两组血压、BPV参数、血脂、血糖的变化幅度不同,联合组变化更明显(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论酒石酸美托洛尔片联合瑞舒伐他汀治疗有助于降低高血压合并T2DM患者的血压、血脂、血糖,且不良反应少。

Objective To observe the effect of metoprolol tartrate tablets combined with rosuvastatin on blood pressure variability(BPV)and glucose and lipid metabolism in patients with hypertension and type 2 diabetes mellitus(T2DM).Methods A total of 108 patients with hypertension and T2DM admitted to the 986th Hospital of Air Force from Jan.2018 to Jan.2021 were included,and they were divided into a single drug group and a combined group,with 54 cases in each group.The single drug group was given metoprolol tartrate tablets(25 mg each time,3 times a day),and the combined group was given metoprolol tartrate tablets(the same method as the single drug group)combined with rosuvastatin(10 mg each time,once a day).Both groups were given continuous medication for 8 weeks.The following parameters before and after treatment were compared between the two groups,including daytime systolic blood pressure(dSBP),daytime diastolic blood pressure(dDBP),nighttime systolic blood pressure(nSBP),nighttime diastolic blood pressure(nDBP),24 h systolic blood pressure(24 h SBP),and 24 h diastolic blood pressure(24 h DBP),BPV parameters[including daytime systolic pressure standard deviation(dSSD),daytime diastolic pressure standard deviation(dDSD),nighttime systolic pressure standard deviation(nSSD),of nighttime diastolic pressure standard deviation(nDSD),of 24 h systolic pressure standard deviation(24 h SSD),24 h diastolic pressure standard deviation(24 h DSD)],blood lipids[including triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],blood glucose[including fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG)],as well as the occurrence of adverse reactions in both groups.Results The main effects of blood pressure(dSBP,dDBP,nSBP,nDBP,24 h SBP,24 h DBP),BPV parameters(dSSD,dDSD,nSSD,nDSD,24 h SSD,24 h DSD),lipid indexes(TG,TC,LDL-C,HDL-C)and blood glucose(FBG,2 h PG)before and after treatment were significantly different(P<0.01);Regardless of the measurement time,the main effect differences of blood pressure,BPV parameters,blood lipids and blood glucose between the two groups were statistically significant(P<0.05 or P<0.01);there were interactions between the time points and groups in blood pressure,BPV parameters,blood lipids and blood glucose(P<0.05);After treatment,blood pressure parameters(dSBP,dDBP,nSBP,nDBP,24 h SBP,24 h DBP),BPV parameters(dSSD,dDSD,nSSD,nDSD,24 h SSD,24 h DSD),TG,TC,LDL-C,and blood glucose(FBG,2 h PG)levels were all lower than before treatment(P<0.05),while HDL-C levels were higher than before treatment(P<0.05),the changes in blood pressure,BPV parameters,blood lipids,and blood glucose were different between the two groups,with the combined group showing more significant changes(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Metoprolol tartrate tablet combined with rosuvastatin is helpful to reduce blood pressure,blood lipid and blood sugar in patients with hypertension and T2DM,and has few adverse reactions.