氨氯地平、坎地沙坦联合应用对老年高血压并发2型糖尿病患者尿微量白蛋白的影响

目的:评价联合应用钙拮抗剂(左旋氨氯地平)和血管紧张素Ⅱ受体拮抗剂(ARB)(坎地沙坦)类药物及单用对老年高血压并发2型糖尿病患者血压及尿微量白蛋白(MAU)的影响。方法:高血压并发2型糖尿病伴尿微量白蛋白阳性门诊患者90例,随机分为联合用药组(左旋氨氯地平5 mg/d+坎地沙坦8 mg/d,n=30)、单用左旋氨氯地平组(5 mg/d,n=30)和单用坎地沙坦组(8 mg/d,n=30)。治疗2周后单用组剂量加倍以达到目标血压,疗程共3个月。记录治疗前后血压、MAU的变化及可能发生的不良事件。结果:治疗3个月后3组血压均较治疗前明显下降(P<0.01),但治疗后3组间血压比较差异无统计学意义;尿微量白蛋白3组均较治疗前减少(P<0.05);两个单用组与联合用药组MAU比较,P均<0.05,差异有统计学意义。结论:钙拮抗剂类药物和ARB类药物联用较单一药物剂量加倍对血压控制情况没有明显差异,但能明显改善老年高血压并发2型糖尿病患者的早期肾损害,提示有早期肾损害者应尽早联合降压治疗。

Effect of Two Kinds of Drugs Combination Therapy Amlodipine,Candesartan on Microalbuminuria in Elderly Patients with Type 2 Diabetes Mellitus and Hypertension

Objective:To evaluate the effect of microalbuminuria of combined treatment with calcium antagonist(levoamlodipine)(CCB)and the ARB(candesartan),or levoamlodipine,candesartan monotherapy in elderly patients with type 2 diabetes mellitus and hypertension.Methods:Ninety cases of consecutive patients with type 2 diabetes mellitus and hypertension were randomized to receive levoamlodipine 5mg/d(n=30),candesartan 8mg/d(n=30),or a combination of levoamlodipine 5mg/d and candesartan 8mg/d(n=30)for 3 months.After 2 ...