摘要
目的 比较硝苯地平与氨氯地平联合吡格列酮治疗老年2型糖尿病并高血压患者的疗效。方法 选取2022年1—12月蚌埠医科大学第二附属医院收治的老年2型糖尿病并高血压患者110例,以等距随机抽样法分为硝苯地平组(采用硝苯地平联合吡格列酮治疗3个月)及氨氯地平组(采用氨氯地平联合吡格列酮治疗3个月),各55例。比较2组治疗前与治疗3个月后血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血压(收缩压、舒张压)、胰岛功能指标(空腹胰岛素、胰岛素抵抗指数)、血小板指标(血小板计数、平均血小板体积)、凝血功能指标(凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、血浆纤维蛋白原)及不良反应。结果 治疗3个月后,2组空腹血糖、餐后2 h血糖、糖化血红蛋白及收缩压、舒张压、空腹胰岛素水平、胰岛素抵抗指数较治疗前下降(P<0.01),但氨氯地平组与硝苯地平组比较差异无统计学意义(P>0.05);2组血小板计数、平均血小板体积及血浆纤维蛋白原水平较治疗前下降,凝血酶原时间、活化部分凝血活酶时间、凝血酶时间较治疗前延长(P<0.01),但氨氯地平组与硝苯地平组比较差异无统计学意义(P>0.05)。氨氯地平组与硝苯地平组不良反应总发生率比较,差异无统计学意义(9.09%vs. 10.91%,χ^(2)=0.101,P=0.751)。结论 硝苯地平与氨氯地平联合吡格列酮治疗老年2型糖尿病并高血压的疗效相当,均可有效降低患者血压、血糖水平,维持胰岛功能、凝血功能、血小板功能稳定,且安全性均较高,临床可根据患者情况合理选择用药方案。
Objective To compare the efficacy of nifedipine or amlodipine combined with pioglitazone in the treatment of elderly type 2 diabetes mellitus patients with hypertension.Methods A total of 110 cases of elderly type 2 diabetes mellitus patients with hypertension admitted to the Second Affiliated Hospital of Bengbu Medical University from January to December 2022 were selected,and they were divided into the nifedipine group which were treated with nifedipine combined with pioglitazone for 3 months and the amlodipine group which were treated with amlodipine combined with pioglitazone for 3 months by equidistant random sampling method,with 55 cases in each group.Blood glucose(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin),blood pressure(systolic blood pressure,diastolic blood pressure),insulin function indexes(fasting insulin,insulin resistance index),platelet indexes(platelet count,average platelet volume),coagulation indexes(prothrombin time,activated partial thromboplastin time,thrombin time,plasma fibrinogen)before and after 3 months of treatment,and adverse reactions in the two groups were compared.Results After 3 months of treatment,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,systolic blood pressure,diastolic blood pressure,fasting insulin,insulin resistance index in the two groups were lower(P<0.01),and there was no significant difference of the indexes between the amlodipine group and the nifedipine group(P>0.05);Platelet count,average platelet volume and plasma fibrinogen level of the two groups were lower,prothrombin time,activated partial thromboplastin time,thrombin time were prolonged(P<0.01),and there was no significant difference of the indexes between the amlodipine group and the nifedipine group(P>0.05).There was no significant difference in incidence of adverse reactions between the amlodipine group and the nifedipine group(9.09%vs.10.91%,χ2=0.101,P=0.751).Conclusion Nifedipine or amlodipine combined with pioglitazone have equivalent effect in the treatment of elderly type 2 diabetes mellitus patients with hypertension,it can effectively reduce the patients′blood pressure and blood glucose,maintain the insulin function,coagulation function,platelet function stable,and with higher safety,it depends on the patients′condition.
作者
樊永强
唐伟
王迪文
FAN Yongqiang;TANG Wei;WANG Diwen(Department of Pharmacy,the Second Affiliated Hospital of Bengbu Medical University,Anhui Province,Bengbu 233000,China)
出处
《临床合理用药杂志》
2024年第9期12-15,共4页
Chinese Journal of Clinical Rational Drug Use
