胰岛素联合阿卡波糖对T2DM合并高血压患者血糖、血脂、血压的影响

目的:观察胰岛素联合阿卡波糖对2型糖尿病(T2DM)合并高血压(EH)患者血糖、血脂、血压水平的影响。方法:本院2017年~2018年的92例T2DM+EH患者被随机均分为胰岛素组(在常规治疗基础上加用胰岛素)和联合治疗组(在胰岛素组基础上加用阿卡波糖),疗程3个月。观察比较两组治疗前后血糖、血脂、血压、肝肾功能水平,以及不良反应发生率。结果:与胰岛素组比较,联合治疗组治疗后空腹血糖[(7.34±1.25)mmol/L比(6.52±1.01)mmol/L]、餐后2h血糖[(10.83±2.83)mmol/L比(9.61±1.98)mmol/L]、糖化血红蛋白[(7.72±2.03)%比(6.85±1.73)%]水平、血糖达标时间[(12.56±5.31)d比(7.12±4.02)d]、总胆固醇[TC,(4.43±1.24)mmol/L比(3.45±1.03)mmol/L]、甘油三酯[TG,(1.21±0.71)mmol/L比(0.91±0.62)mmol/L]、低密度脂蛋白胆固醇[LDL-C,(2.79±0.81)mmol/L比(1.12±0.73)mmol/L]、24h平均收缩压[(138.69±11.25)mmHg比(125.28±10.62)mmHg]、24h平均舒张压[(90.38±8.92)mmHg比(86.11±8.18)mmHg]、收缩压负荷[(26.51±6.98)%比(20.38±6.02)%]、舒张压负荷[(25.07±6.41)%比(21.19±5.92)%]均显著降低,高密度脂蛋白胆固醇[HDL-C,(1.34±0.25)mmol/L比(1.93±0.27)mmol/L]水平显著升高,P<0.05或<0.01。联合治疗组不良反应发生率显著低于胰岛素组(13.04%比32.61%),P=0.025。结论:胰岛素联合阿卡波糖能够显著降低患者血糖、血脂、血压水平,起效更快,且用药安全,值得推广。

Influence of insulin combined acarbose on blood glucose,blood lipids and blood pressure in patients with T2DM complicated hypertension

Objective:To observe influence of insulin combined acarbose on levels of blood glucose,blood lipids and blood pressure(BP)in patients with type 2 diabetes mellitus(T2DM)complicated essential hypertension(EH).Methods:A total of 92 T2DM+EH patients treated in our hospital from 2017 to 2018 were randomly and equally divided into insulin group(received insulin based on routine treatment)and combined treatment group(received acarbose based on insulin group),course of treatment was three months both.Levels of blood glucose,blood lipids,blood pressure,liver and kidney function indexes before and after treatment,and incidence rate of adverse reactions were observed and compared between two groups.Results:Compared with insulin group after treatment,there were significant reductions in levels of fasting plasma glucose[(7.34±1.25)mmol/L vs.(6.52±1.01)mmol/L],2h postprandial blood glucose[(10.83±2.83)mmol/L vs.(9.61±1.98)mmol/L],glycosylated hemoglobin A1c[(7.72±2.03)%vs.(6.85±1.73)%],blood glucose standard-reaching time[(12.56±5.31)d vs.(7.12±4.02)d],total cholesterol[(4.43±1.24)mmol/L vs.(3.45±1.03)mmol/L],triglyceride[(1.21±0.71)mmol/L vs.(0.91±0.62)mmol/L],low density lipoprotein cholesterol[(2.79±0.81)mmol/L vs.(1.12±0.73)mmol/L],24h mean systolic blood pressure[(138.69±11.25)mmHg vs.(125.28±10.62)mmHg],24h mean diastolic blood pressure[(90.38±8.92)mmHg vs.(86.11±8.18)mmHg],SBP burden[(26.51±6.98)%vs.(20.38±6.02)%],DBP burden[(25.07±6.41)%vs.(21.19±5.92)%],and significant rise in level of high density lipoprotein cholesterol[(1.34±0.25)mmol/L vs.(1.93±0.27)mmol/L]in combined treatment group,P<0.05 or<0.01.Incidence rate of adverse reactions in combined treatment group was significantly lower than that of insulin group(13.04%vs.32.61%),P=0.025.Conclusion:Insulin combined acarbose can significantly reduce levels of blood glucose,blood lipids and BP in T2DM+EH patients.It works faster with high safety,which is worth extending.