度拉糖肽联合厄贝沙坦治疗2型糖尿病合并高血压患者的临床效果研究

Clinical study of dulaptide combined with irbesartan in patients with type 2 diabetes mellitus and hypertension

目的 分析度拉糖肽联合厄贝沙坦治疗2型糖尿病合并高血压患者的临床疗效。方法 采用随机数字表法将收治的2型糖尿病合并高血压患者98例分为对照组及观察组,每组49例。对照组采用基础胰岛素联合厄贝沙坦治疗,观察组采用度拉糖肽联合厄贝沙坦治疗。比较两组患者的疗效,血糖指标[空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)],血压,血清同型半胱氨酸(Hcy)和脑钠肽(BNP)水平。结果 观察组治疗总有效率为95.92%,远高于对照组的77.55%,组间比较差异显著(P<0.05)。治疗后两组空腹血糖、餐后2 h血糖、HbA1c、HOMA-IR均较治疗前降低, HOMA-β则有所提高,且与对照组比较,观察组空腹血糖(6.41±1.23)mmol/L、餐后2 h血糖(8.72±1.45)mmol/L、HbA1c(6.32±0.41)%、HOMA-IR(3.15±0.25)低于对照组的(8.82±1.26)mmol/L、(12.82±2.16)mmol/L、(7.32±0.21)%、(4.12±0.11), HOMA-β(96.52±9.56)高于对照组的(90.58±8.71)(P<0.05)。治疗后两组舒张压、收缩压均明显降低,且与对照组比较,观察组舒张压(81.62±5.12)mm Hg(1 mm Hg=0.133 kPa)、收缩压(128.52±5.62)mm Hg低于对照组的(89.92±6.52)、(132.52±4.63)mm Hg(P<0.05)。治疗后两组Hcy、BNP水平均明显降低,且与对照组比较,观察组Hcy(14.23±2.15)μmol/L、BNP(68.82±19.52)pg/ml低于对照组的(17.82±2.11)μmol/L、(89.82±17.54)pg/ml(P<0.05)。结论 对2型糖尿病合并高血压患者应用度拉糖肽联合厄贝沙坦治疗可明显降低患者血糖及血压水平,改善胰岛素抵抗及胰岛β细胞功能,对靶器官功能起到一定的保护作用,减少损伤,应用价值高。

Objective To analyze the clinical efficacy of dulaptide combined with irbesartan in patients with type 2 diabetes mellitus and hypertension.Methods 98 patients with type 2 diabetes mellitus and hypertension were divided into a control group and an observation group by random number table method,with 49 cases in each group.The control group was treated with basal insulin and irbesartan,and the observation group was treated with dulaglutide and irbesartan.Comparison was made on therapeutic effect,blood glucose indicators[fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance index(HOMA-IR),homeostasis model assessment ofβ-cell function(HOMA-β)],blood pressure,serum homocysteine(Hcy)and brain natriuretic peptide(BNP)between the two groups.Results The total effective rate of the observation group was 95.92%,which was much higher than 77.55%of the control group(P<0.05).After treatment,the fasting blood glucose,2 h postprandial blood glucose,HbA1c,HOMA-IR in both groups decreased compared to those before treatment,while HOMA-βwas increased compared to that before treatment;the observation group had fasting blood glucose of(6.41±1.23)mmol/L,2 h postprandial blood glucose of(8.72±1.45)mmol/L,HbA1c of(6.32±0.41)%,HOMA-IR of(3.15±0.25),which were lower than(8.82±1.26)mmol/L,(12.82±2.16)mmol/L,(7.32±0.21)%,(4.12±0.11)in the control group;HOMA-βof(96.52±9.56)in the observation group was higher than(90.58±8.71)in the control group(P<0.05).After treatment,the diastolic blood pressure and systolic blood pressure decreased significantly in both groups;the observation group had diastolic blood pressure of(81.62±5.12)mm Hg(1 mm Hg=0.133 kPa)and systolic blood pressure of(128.52±5.62)mm Hg,which were lower than(89.92±6.52)and(132.52±4.63)mm Hg in the control group(P<0.05).After treatment,the levels of Hcy and BNP were significantly decreased in both groups;the observation group had Hcy of(14.23±2.15)μmol/L and BNP of(68.82±19.52)pg/ml,which were lower than(17.82±2.11)μmol/L and(89.82±17.54)pg/ml in the control group(P<0.05).Conclusion In patients with type 2 diabetes mellitus and hypertension,dulaptide combined with irbesartan can significantly reduce blood glucose and blood pressure levels,improve insulin resistance and islet beta cell function,and play a certain protective role in target organ function,reduce damage,and has high application value.