替米沙坦联合羟苯磺酸钙治疗非杓型高血压合并2型糖尿病疗效的研究

Study on the application value of telmisartan combined with calcium dobesilate in patients with non-dipper hypertension complicated with type 2 diabetes mellitus

目的探讨替米沙坦联合羟苯磺酸钙治疗非杓型高血压合并T2DM的疗效。方法选取2021年1月至2022年12月于我院内分泌科门诊就诊的非杓型高血压合并T2DM患者260例,根据随机数字表法分为替米沙坦治疗组(Tel,n=110)和替米沙坦+羟苯磺酸钙治疗组(Tel+Cal-dob,n=150)。比较两组血压水平、血压节律变化、肱动脉血管内皮依赖性舒张功能(FMD)、颈桡动脉脉搏波传导速度(cr PWV)、一氧化氮(NO)、内皮素-1(ET-1)、VEGF及不良反应发生率。结果两组一般资料及生化指标比较,差异无统计学意义(P>0.05)。治疗3、6、12个月后,两组FMD、NO高于治疗前,日间平均收缩压(d SBP)、日间平均舒张压(d DBP)、24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP)、cr PWV、ET-1、VEGF低于治疗前(P<0.05),Tel+Cal-dob组FMD、NO高于Tel组,d SBP、d DBP、24 hSBP、24 hDBP、n SBP、n DBP、cr PWV、ET-1、VEGF低于Tel组(P<0.05),Tel+Cal-dob组杓型血压转变率高于Tel组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论替米沙坦联合羟苯磺酸钙治疗非杓型高血压合并T2DM疗效较替米沙坦单药治疗更佳。

Objective To explore the application value of telmisartan combined with calcium dobesilate in patients with non-dipper hypertension complicated with type 2 diabetes mellitus(T2DM).Methods A total of 260 patients with non-dipper hypertension complicated with T2DM in the endocrinology department of our hospital were selected in this study from January 2021 to December 2022.All the patients were randomly divided into telmisartan group(Tel,n=110)and telmisartan+calcium dobesilate group(Tel+Cal-dob,n=150).The blood pressure level,blood pressure rhythm changes,brachial flow mediated dilatation(FMD),carotid radial pulse wave velocity(crPWV),vasomotor factors[nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF)]and the incidence of adverse reactions were compared between the two groups.Results There was no significant difference in general data and biochemical indexes between the two groups(P>0.05).After 3,6 and 12 months of treatment,the FMD and NO were higher,while the d SBP,d DBP,24 h SBP,24 h DBP,n SBP,n DBP,cr PWV,ET-1 and VEGF were lower than before treatment in both groups(P<0.05).After 3,6 and 12months of treatment,the FMD and NO were higher,while dSBP,d DBP,24 hSBP,24 hDBP,n SBP,n DBP,cr PWV,ET-1 and VEGF were lower in Tel+Cal-dob group than in Tel group(P<0.05).After 3,6 and 12 months of treatment,the conversion rates of dipper blood pressure were higher in Tel+Cal-dob groupthan in Tel group(P<0.05).There was no significant difference in the incidence of adverse effects between the two groups(P>0.05).Conclusion Telmisartan combined with calcium dobesilate is effective in the treatment of patients with non-dipper hypertension complicated with T2DM.