摘要
目的研究血管紧张素转换酶抑制剂(ACET)和珍菊降压片对2型糖尿病伴与不伴高血压者的血浆内皮素(ET)、一氧化氮(NO)水平的影响,指导临床药物的选择。方法 2型糖尿病患者112例,其中合并高血压(EH组)58例,Ⅰ亚组(30例)予盐酸贝那普利口服10 mg/d,每日1次;Ⅱ亚组(28例)予珍菊降压片1片/次, 每日3次。两组中血压控制不佳者,均加用双氢克尿噻25 mg/d,每日1次治疗。不伴高血压(NEH组)54例,分为Ⅲ亚组(28例),予盐酸贝那普利口服5 mg/d(ⅢA亚组)或10 mg/d(ⅢB亚组),每日1次;Ⅳ亚组(26例),仅予降糖治疗。以上各组随访用药时间均为1个月。结果①EH组中,Ⅰ亚组治疗后ET-1、NO水平分别为显著下降和升高(P<0．01),Ⅱ亚组用药后ET-1水平显著下降(P<0．05),而NO水平无明显变化。②NEH组中,Ⅲ亚组治疗后ET-1水平明显下降(P<0．05),并且NO水平显著升高(P<0．01),而无论是ⅢA亚组还是ⅢB亚组,NO水平均显著升高,ET-1均显著降低水平(P<0．05),两者间的差异无显著性。结论糖尿病伴与不伴高血压者的血浆ET、NO水平均处在不平衡状态,且ACEI的疗效优于珍菊降压片。常规或者小剂量的ACEI均能起到调节ET、NO水平的作用。
Objective To study the effects of ACEI and Zhenju Jiangya tablet on plasma ET, NO in type 2 diabetes patients with or without hypertension, and to choose the right medication at clinical practice. Methods Among 112 cases of type 2 diabetes; 58 cases constitued hypertension group（EH） which were randomly divided into ACEI group 30 cases with Lotensin 10 mg/d and Zhenju Jiangya tablet group 28 cases with 1 # tid; 54 cases were enroled in without hypertension group, ACEI group of 28 cases： Lotensin 5 mg/d 15 cases and Lotensin 10 mg/d 13 cases, and control group of 26 cases followed up for 1 month, ET, NO were tested before and after giving the treatment. Results ①In type 2 diabetes with hypertension group, Lotensin can significantly reduce and elevate the plasma levels of ET and NO （P〈0.01）. Zhenju could only decrease ET （P 〈 0.05）, but could not change NO. ②In type 2 diabetes without hypertension group, Lotensin could significantly decrease ET （P 〈 0.05） and obviously increase NO （P 〈0.01 ）, Whatever under the dosages of 5 mg/d or 10 rag/d, Lotensin could elevate NO level and reduce ET （P 〈0.05）, no difference was seen in the two dosages. Conclusion The plasma ET and NO levels are in a state of imbalance in type 2 diabetes patients with or without hypertension. To modulate the levels of ET and NO, ACEI is better than Zhenju Jiangya tablet with either routine or small dosage of ACEI. （Shanghai Med J, 2006, 29：227-229）
出处
《上海医学》
CAS
CSCD
北大核心
2006年第4期227-229,共3页
Shanghai Medical Journal
