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目的比较替米沙坦与雷米普利治疗慢性心力衰竭(CHF)合并2型糖尿病(T2DM)的疗效和安全性。方法 87例CHF合并T2DM患者随机分为替米沙坦组80mg/d和雷米普利组10mg/d,口服治疗12周后比较两组患者治疗CHF的总有效率,左心室心功能,6min步行距离,空腹血糖(FPG)和空腹胰岛素(FINS)水平的变化,并观察不良反应。结果替米沙坦组控制CHF总有效率为86.7%,雷米普利组控制CHF总有效率为73.8%,两组间总有效率无统计学差异。两组患者左心室功能均明显改善(P<0.05),替米沙坦组较雷米普利组改善更明显(P<0.05)。两组患者治疗后6min步行距离较治疗前均明显改善(P<0.05)。替米沙坦组患者治疗后FINS水平显著降低(P<0.05)。结论替米沙坦(80mg/d)和雷米普利(10mg/d)均可以有效控制CHF,但替米沙坦治疗不良反应少,同时可以降低空腹胰岛素水平,对于CHF合并2型糖尿病的患者治疗效果优于雷米普利。
Objective To compare the efficacy and safety of telmisartan and ramipril in the treatment of type 2 diabetes mellitus (T2DM) with chronic heart failure (CHF). Methods 87 patients with CHF and T2DM were randomly divided into telmisartan group 80 mg / d and ramipril group 10 mg / d. After oral treatment for 12 weeks, the total effective rate of treatment of CHF, left ventricular cardiac function, Walking distance, fasting blood glucose (FPG) and fasting insulin (FINS) levels, and to observe the adverse reactions. Results The total effective rate of CHF controlled by telmisartan was 86.7%. The total effective rate of CHF controlled by ramipril was 73.8%. The total effective rate was no significant difference between the two groups. Left ventricular function was significantly improved in both groups (P <0.05), and telmisartan group improved more significantly than ramipril group (P <0.05). The walking distance at 6min after treatment in both groups was significantly improved compared with that before treatment (P <0.05). FINS levels in patients treated with telmisartan were significantly decreased (P <0.05). Conclusion Telmisartan (80mg / d) and ramipril (10mg / d) can effectively control CHF, but telmisartan treatment of adverse reactions less, and can reduce fasting insulin levels, CHF for type 2 diabetes mellitus Patients treated better than ramipril.