福辛普利治疗老年2型糖尿病合并轻中度高血压的临床疗效

目的评价福辛普利治疗老年2型糖尿病合并轻中度高血压的临床疗效及其安全性。方法23例老年2型糖尿病合并轻中度高血压患者服用福辛普利10～40mg，1/d、疗程6周，采用随机测血压和24小时动态血压监测。同时监测治疗前后空腹血糖、空腹胰岛素、糖化血红蛋白、血脂(TC、TG、HDL、LDL)、肾功(BUN、Cr、BUA)及尿微量白蛋白/尿肌酐变化。结果谷峰比率收缩压为72.6%±8.5%，舒张压为59.5%±8.1%。治疗后，24h平均收缩压、白昼平均收缩压、夜间平均收缩压和血压负荷值均显著下降(P＜0.01)，而24h平均舒张压、夜间平均舒张压、24h平均血压、夜间平均血压亦有明显的下降(P＜0.05)。治疗后空腹血糖、糖化血红蛋白及空腹胰岛素均明显降低(P＜0.05)，而血脂(TC、TG、HDL、LDL)肾功(BUN、Cr、BUA)无明显改变，尿微量白蛋白/尿肌酐明显降低(P＜0.05)。结论福辛普利是治疗老年2型糖尿病合并轻中度高血压的安全、有效、耐受良好的药物。

The Clinical Effects ofFosinopril on the Treatment for Type 2 Diabetes Complicated with Mild and ModerateHypertension in the Elderly

Objective To assess the clinical efficacy and safety ofFosinopril on the treatment for type 2 diabetics complicated with mild and moderate hypertension in the elderly. Methods 23 elderly type 2 diabetics with mild and moderate hypertension, who took 10～40 mg Fosinopril per day for 6 weeks, were observed. And some other indices, including casual blood pressure ambulatory blood pressure monitoring, fasting blood glucose (FBG), fasting insulin (FINS), HbA1C, serum lipids, kidney function and A/C in urine, were measured before and after treatment, respectively. Results Trough to peak ratio of SBP and DBP were 72.6%±8.5% and 59.5%±8.1%,respectively. After therapy, 24 h mean SBP, day mean SBP, night mean SBP and blood pressure burden were significantly reduced(P＜0.01); 24 h mean DBP, night mean BP, 24 h mean BP and night mean BP were markedly reduced(P＜0.05). Meanwhile, FBG, HbA1C, FINS and A/C decreased significantly (P＜0.05); but blood lipids (TG, TC, HDL, LDL) and kidney function (BUN, CR, BUA) were not changed (P＞0.05). Conclusion Fosinopril is effective, safe and well-tolerated medicine for type 2 diabetics complicated with mild to moderate hypertension in the elderly.