左旋氨氯地平联合福辛普利治疗原发性高血压合并2型糖尿病的临床观察

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。

Clinical Observation of Combinative Treatment Effects of Levamlodipine and Fosinopril in Patients with Essential Hypertension and Type 2 Diabetesmellitus

Objective To investigate the combinative treatment effects of Levamlodipine and Fosinopril in Patients with Essential Hypertension and Type 2 Diabetesmellitus. Methods 190 patients with Essential Hypertension and Type 2 Diabetesmellitus whose blood glucose were well controlled were divided randomly into 3 groups. Group 1 was treated by levamlodipine, Group 2 was treated by fosinopril, Group 3 was treated by levamlodipine and fosinopril. Observe the changes of their ambulatory blood pressure, 24h-urine microdose protein and intimamedia thickness（IMT） 6 and 12 months later. Results After 6 months, the blood pressure level of all three groups were lowered, and it was more significant in group 3（P〈0.05）,24h-urine microdose protein level were lowered in all three groups; After 12 months, the blood pressure level of all three groups were lowered, and it was more significant in group 3（P〈0.05）,24 hurine microdose protein level were lowered in all three groups, and it was more significant in group 3（P〈0.05）, intimamedia thickness got thinner in group 1 and group 3. Conclusion Combinative Treatment of Levamlodipine and Fosinopril could control blood pressure well, They could also decrease microdose protein and protect the function of Nephrol and delay the progress of atherosclerosis.