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目的观察左旋氨氯地平与福辛普利单用及联合对原发性高血压合并2型糖尿病患者的降压疗效及其他相关临床指标的影响。方法 190例原发性高血压合并2型糖尿病并且严格控制血糖的患者,随机分为3组,分别为左旋氨氯地平组、福辛普利组、左旋氨氯地平+福辛普利组,连续用药12个月,观察治疗前后3组患者的血压控制情况、24小时尿微量蛋白尿及颈动脉内膜中层厚度(IMT)等指标变化情况。结果治疗6个月时,三组患者血压均较治疗前下降,左旋氨氯地平+福辛普利组较单药治疗组下降明显,3组患者24小时尿微量蛋白均下降;治疗12个月时,三组患者血压均较治疗前下降,联合治疗组较单药治疗组下降明显,3组患者24小时尿微量蛋白尿下降,在联合用药组下降更明显,在左旋氨氯地平组及左旋氨氯地平+福辛普利组颈动脉内膜中层厚度较治疗前改善。结论氨氯地平联合福辛普利能够控制原发性高血压合并2型糖尿病患者血压的同时,对降低24小时尿微量蛋白尿保护肾功能及延缓动脉粥样硬化均有益处。
Objective To observe the effects of levamlodipine and fosinopril alone and in combination on antihypertensive effect and other related clinical indexes in patients with essential hypertension complicated with type 2 diabetes mellitus. Methods A total of 190 patients with essential hypertension with type 2 diabetes mellitus and strict control of blood glucose were randomly divided into three groups: levamlodipine group, fosinopril group, levamlodipine + fosinopril group, Continuous medication for 12 months, before and after treatment to observe the three groups of patients with blood pressure control, 24-hour urine microalbuminuria and carotid artery intima-media thickness (IMT) and other indicators change. Results After 6 months of treatment, the blood pressure of the three groups decreased compared with that before treatment. The levamlodipine + fosinopril group decreased significantly compared with the single drug treatment group. The urine microalbumin in 24 hours in all three groups decreased significantly. After treatment for 12 months , The blood pressure of the three groups decreased compared with that before treatment. The combination therapy group decreased significantly compared with the monotherapy group. The 24-hour urine microalbuminuria in the three groups decreased more significantly in combination group and decreased in the levamlodipine group Amlodipine + fosinopril group carotid intima-media thickness than before treatment to improve. Conclusion Amlodipine combined with fosinopril can control the blood pressure in patients with essential hypertension complicated by type 2 diabetes mellitus and at the same time, reduce the protection of renal function and delay the atherosclerosis of 24-hour urine microalbuminuria.