2021 年第 1 期 第 16 卷

厄贝沙坦联合氨氯地平治疗老年糖尿病伴高血压患者的效果观察

Effect of irbesartan combined with amlodipine in elderly patients with diabetes mellitus and hypertension

作者：李沛玲刘丹妮

英文作者：Li Peiling Liu Danni

单位：宁夏回族自治区人民医院老年病科，银川750001

英文单位：Department of Geriatrics People′s Hospital of Ningxia Hui Autonomous Region Yinchuan 750001 China

关键词：糖尿病；高血压；厄贝沙坦；氨氯地平；糖脂代谢；胰岛素抵抗

英文关键词：Diabetesmellitus;Hypertension;Irbesartan;Amlodipine;Glucolipidmetabolism;Insulinresistance

• 摘要：

• 目的 观察厄贝沙坦联合氨氯地平治疗老年糖尿病伴高血压患者的效果。方法 选取2017年1月至2019年12月宁夏回族自治区人民医院收治的400例老年糖尿病伴高血压患者为研究对象。采集随机信封法将400例患者分成观察组和对照组，各200例。所有患者均有饮食运动指导、基础降糖治疗，对照组在常规治疗基础上口服苯磺酸氨氯地平片治疗，观察组在对照组基础上口服厄贝沙坦片治疗，2组均连续治疗8周。比较2组治疗前后血压、糖代谢［空腹血糖、餐后2 h血糖（2 hPBG）、糖化血红蛋白（HbA1c）］、脂代谢［总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）］、稳态模型胰岛β细胞功能指数（HOMA-β）、稳态模型胰岛素抵抗指数（HOMA-IR）水平，并监测用药不良反应。结果 治疗后2组血压、血糖、HOMA-β、HOMA-IR及观察组血脂均较治疗前改善，且观察组收缩压［（131±11）mmHg（1 mmHg=0.133 kPa）比（139±11）mmHg］、舒张压［（73±5）mmHg比（80±6）mmHg］、空腹血糖、2 h PBG、HbA1c［（5.3±0.8）%比（6.0±0.8）%］、总胆固醇［（4.7±0.7）mmol/L比（5.2±1.0）mmol/L］、三酰甘油、LDL-C 及HOMA-IR［（3.8±1.0）比（4.2±0.9）］低于对照组，HOMA-β高于对照组，差异均有统计学意义（均P<0.05）。观察组与对照组不良反应总发生率比较差异无统计学意义［4.5%（9/200）比3.5%（7/200）］（χ2=0.260，P=0.610）。结论 厄贝沙坦联合氨氯地平治疗老年糖尿病伴高血压患者，控制血压效果良好，对改善患者糖脂代谢、胰岛素抵抗有积极意义，且安全性好。

• Objective To observe the application effect of irbesartan combined with amlodipine in elderly patients with diabetes mellitus and hypertension. Methods Totally 400 elderly patients with diabetes mellitus and hypertension admitted to  People′s Hospital of Ningxia Hui Autonomous Region from January 2017 to December 2019 were selected. The patients were randomly divided into observation group and control group, with 200 cases in each group. All patients were given diet and exercise guidance and basic antidiabetic therapy. The control group was treated with amlodipine besylate tablets on the basis of routine treatment, the observation group was treated with irbesartan tablets on the basis of control group. Both groups were treated continuously for 8 weeks. The blood pressure, glucose metabolism ［fasting plasma glucose(FPG), postprandial 2 h blood glucose(2 h PBG), glycosylated hemoglobin(HbA1c)］, lipid metabolism ［total cholesterol, triacylglycerol, low-density lipoprotein cholesterol(LDL-C)］ and homeostatic model assessment islet β-cell function index(HOMA-β) and insulin resistance index(HOMA-IR) were compared between the two groups before and after treatment, and the adverse drug reactions were monitored. Results After treatment, the levels of blood pressure, blood glucose, HOMA-β and HOMA-IR in both groups and blood lipid in observation group were improved compared with those before treatment, and systolic blood pressure［(131±11) mmHg vs (139±11) mmHg］, diastolic blood pressure［(73 ± 5)mmHg vs (80 ± 6) mmHg］, FPG, 2 h PBG, HbA1c［(5.3±0.8)% vs (6.0±0.8)%］, total cholesterol［(4.7±0.7)mmol/L vs (5.2±1.0)mmol/L］, triacyglycerol, LDL-C and HOMA-IR［(3.8±1.0) vs (4.2±0.9)］in observation group were lower than those in the control group, and HOMA-β was higher than that in the control group(all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups［4.5%（9/200） vs 3.5%（7/200）］（χ2=0.260， P=0.610）. Conclusion Irbesartan combined with amlodipine is effective in controlling blood pressure in elderly patients with diabetes mellitus with hypertension, and has positive significance in improving glucose and lipid metabolism and insulin resistance, and has good safety.