前瞻性分析强化降糖和降压治疗对2型糖尿病大血管病变的影响

目的 探讨强化降糖、降压治疗对2型糖尿病大血管病变的影响.方法 以本院2010年12月至2014年12月收治的2型糖尿病患者120例为研究对象,将其随机分为A、B、C、D组,各30例;A组给予强化降糖降压治疗,B组给予单纯强化降糖治疗,C组给予单纯强化降压治疗,D组给予一般性降糖降压治疗;比较分析各组大血管病变发生情况.结果 A组血糖各项指标及IMT与治疗前比较差异均有统计学意义(t=5.171、6.299、6.448、4.557,均P＜0.01);A组、C组患者的收缩压、舒张压与治疗前比较均明显改善(t=13.587、9.117、10.694、7.013,均P＜0.01),分别与B组、D组比较差异均有统计学意义(t=12.229、11.023、10.694、9.859、6.843、6.386、5.988、5.806,均P＜0.01);A组、C组治疗后血压总达标率分别为83.3％和86.7％,均明显高于B组和D组(x2=19.461、24.093、21.991、26.786,均P＜0.01);A组有1例(3.3％)患者发生轻微大血管病变,D组15例(50％),B组、C组分别为10例(33.3％)和9例(30.0％),A组发生率与D组、B组、C组比较差异均有统计学意义(x2=16.705、9.017、7.680,均P＜0.01),B组与C组比较差异无统计学意义(x 2=0.077,P＞ 0.05).结论 相比于单纯强化降糖或降压治疗以及一般降压降糖治疗,强化降糖降压治疗2型糖尿病,能有效预防患者大血管病变的发生,具有较高的临床应用价值.

Influence of strengthened hypoglycemic and antihypertensive treatment on macrovascular in patients with type 2 diabetes

Objective To investigate the influence of strengthened hypoglycemic and antihypertensive treatment on macrovascular in patients with type 2 diabetes.Methods 120 with patients type 2 diabetes treated at our hospital from December,2010 to December,2014 were set as study objects and were randomly divided into group A,group B,group C,and group D,30 for each group.Group A was given intensive hypoglycemic and antihypertensive treatment,group B intensive glycemic therapy,group C strengthened antihypertensive treatment,and group D general hypoglycemic and antihypertensive treatment.The occurrences of macrovascular disease of the groups were compared and analyzed.Results There were statistical differences in blood glucose indexes and IMT in group A between before and after treatment (t =5.171,6.299,6.448,4.557,P ＜ 0.01).There were statistical differences in systolic and diastolic blood pressures in group A and group C between before and after treatment (t =13.587,9.117,10.694,7.013,P ＜ 0.01) and between those in group A and group C and those in group B and group D after treatment (t =12.229,11.023,10.694,9.859,6.843,6.386,5.988,5.806,P ＜ 0.01).The target-blood-pressure-achieved rate was 83.3％ in group A and was 86.7％ in group C,which were higher than those in group B and group D (x 2=19.461,24.093,21.991,26.786,P ＜ 0.01).1 case (3.3％) got mild vascular disease in group A,15 (50.0％) in group D,10 (33.3％) in group B,and 9 (30.0％) in group C,with statistical the differences between that in group A and those in group B,C,and D (x 2=16.705,9.017,7.680,P ＜ 0.01) but no between group B and group C (x 2=0.077,P ＞ 0.05).Conclusions Intensive hypoglycemic and antihypertensive treatment for type 2 diabetes is more effective than hypoglycemic or antihypertensive treatment and general hypoglycemic and antihypertensive therapy a d can effectively prevent the occurrence of macrovascular disease,so it has high clinical application value.