格列美脲联合吡格列酮治疗老年2型糖尿病合并高血压患者的疗效分析
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摘要
目的探讨格列美脲联合吡格列酮治疗老年2型糖尿病合并高血压患者的疗效。方法选取2017年6月～2018年5月我院收治的2型糖尿病合并高血压患者120例,按随机数字表法分为观察组和对照组,各60例。对照组给予吡格列酮,观察组在对照组的基础上给予格列美脲,比较两组治疗前、治疗后第6个月的血糖、血脂、血压水平以及不良反应发生率。结果治疗后,观察组FPG、HbA1c低于对照组[(6.25±0.79)mmol/L vs(6.73±0.81)mmol/L、(5.90±1.12)%vs(6.39±1.33)%],差异有统计学意义(P<0.05)。观察组TC、TG低于对照组[(4.76±0.96)mmol/L vs(5.22±1.01)mmol/L、(1.60±0.64)mmol/L vs(1.60±0.64)mmol/L],差异有统计学意义(P<0.05);两组LDL-C、HDL-C比较,差异无统计学意义(P>0.05)。观察组SBP低于对照组[(125.36±12.87)mmHg vs(132.35±13.58)mmHg],差异有统计学意义(P<0.05);两组DBP比较,差异无统计学意义(P>0.05)。观察组不良反应发生率为6.67%,低于对照组的10.00%,但差异无统计学意义(P>0.05)。结论吡格列酮联合格列美脲能有效改善老年2型糖尿病合并高血压患者的血糖、血脂和血压水平,且联合用药改善效果优于单独用药,且具有较高的安全性。
Objective To investigate the efficacy of glimepiride combined with pioglitazone in the treatment of elderly patients with type 2 diabetes mellitus complicated with hypertension. Methods A total of 120 patients with type 2 diabetes mellitus complicated with hypertension admitted to our hospital from June 2017 to May 2018 were enrolled. The patients were divided into observation group and control group by random number table, 60 cases each. Pioglitazone was given to the control group, and glimepiride was given to the observation group on the basis of the control group. The blood glucose, blood lipid and blood pressure levels and the incidence of adverse reactions were compared before treatment and at 6 months after treatment.Results After treatment, the FPG and HbA1 c in the observation group were lower than the control group [(6.25 ±0.79)mmol/L vs(6.73±0.81)mmol/L,(5.90±1.12) % vs(6.39±1.33)%], the difference was statistically significant(P<0.05). The TC and TG in the observation group were lower than those in the control group [(4.76 ±0.96) mmol/L vs(5.22 ±1.01)mmol/L,(1.60 ±0.64)mmol/L vs(1.60 ±0.64)mmol/L], and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in LDL-C and HDL-C(P>0.05). The SBP of the observation group was lower than that of the control group[(125.36±12.87)mmHg vs(132.35±13.58)mmHg], the difference was statistically significant(P<0.05).There was no significant difference in DBP between the two groups(P>0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than that in the control group, but the difference was not statistically significant(P>0.05). Conclusion Pioglitazone combined with glimepiride can effectively improve blood glucose, blood lipids and blood pressure in elderly patients with type 2 diabetes mellitus complicated with hypertension,and the combined use of the drug is better than the single drug, and has a high safety.
Objective To investigate the efficacy of glimepiride combined with pioglitazone in the treatment of elderly patients with type 2 diabetes mellitus complicated with hypertension. Methods A total of 120 patients with type 2 diabetes mellitus complicated with hypertension admitted to our hospital from June 2017 to May 2018 were enrolled. The patients were divided into observation group and control group by random number table, 60 cases each. Pioglitazone was given to the control group, and glimepiride was given to the observation group on the basis of the control group. The blood glucose, blood lipid and blood pressure levels and the incidence of adverse reactions were compared before treatment and at 6 months after treatment.Results After treatment, the FPG and HbA1 c in the observation group were lower than the control group [(6.25 ±0.79)mmol/L vs(6.73±0.81)mmol/L,(5.90±1.12) % vs(6.39±1.33)%], the difference was statistically significant(P<0.05). The TC and TG in the observation group were lower than those in the control group [(4.76 ±0.96) mmol/L vs(5.22 ±1.01)mmol/L,(1.60 ±0.64)mmol/L vs(1.60 ±0.64)mmol/L], and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in LDL-C and HDL-C(P>0.05). The SBP of the observation group was lower than that of the control group[(125.36±12.87)mmHg vs(132.35±13.58)mmHg], the difference was statistically significant(P<0.05).There was no significant difference in DBP between the two groups(P>0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than that in the control group, but the difference was not statistically significant(P>0.05). Conclusion Pioglitazone combined with glimepiride can effectively improve blood glucose, blood lipids and blood pressure in elderly patients with type 2 diabetes mellitus complicated with hypertension,and the combined use of the drug is better than the single drug, and has a high safety.
引文
[1]Cosenso-Martin LN,Giollo-Júnior LT,Fernandes LAB,et al.Effect of vildagliptin versus glibenclamide on endothelial function and arterial stiffness in patients with type 2 diabetes and hypertension:a randomized controlled trial[J].Acta Diabetologica,2018,55(12):1237-1245.
[2]Arévalo-Lorido JC,Gómez JC,Huelgas RG,et al.Lowering Blood Pressure with the Combination of a Sodium-Glucose Cotransporter 2 Inhibitor and a Glucagon-like Peptide-1 Receptor Agonist in Type 2 Diabetic Patients:A Clinical Evidence[J].High Blood Press Cardiovasc Prev,2018,25(4):417-420.
[3]巴俊强,高洪蛟,许祥林,等.运动性高血压与2型糖尿病及胰岛素抵抗的相关性研究[J].第三军医大学学报,2016,38(20):2279-2282.
[4]Zhang HW,Zhao X,Guo YL,et al.Elevated lipoprotein(a)levels are associated with the presence and severity of coronary artery disease in patients with type 2 diabetes mellitus[J].Nutr Metab Cardiovasc Dis,2018,28(10):980-986.
[5]赵静,刘进娜,王帮众,等.2型糖尿病并发高血病的相关机制研究及中药复方的干预作用实验研究[J].中华中医药杂志,2016,31(9):3703-3706.
[6]李英昭,郭向阳,尹洪涛,等.西格列汀对需要大剂量胰岛素治疗的老年T2DM患者胰岛素抵抗及血糖波动的影响[J].重庆医学,2017,46(32):34-38.
[7]Young LH,Viscoli CM,Schwartz GG,et al.Heart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone[J].Circulation,2018,138(12):1210-1220.
[8]张四青,习燕华,钟树妹,等.格列美脲联合二甲双胍对新诊断2型糖尿病伴非酒精性脂肪肝病患者胰岛素抵抗和胰岛β细胞功能的影响[J].中国全科医学,2016,19(5):525-528.
[9]Martin R,Julio R,Robert AK,et al.Empagliflozin compared with glimepiride in metformin-treated patients with type 2 diabetes:208-week data from a masked randomized controlled trial[J].Diabetes Obes Metab,2018,20(12):2768-2777.
[10]陈芳,卢岚敏,韩白玉,等.2型糖尿病体重变化与心血管疾病关系[J].中国糖尿病杂志,2017,25(2):185-188.
[11]蒲丹岚,尹经霞,谢洁,等.复方盐酸吡格列酮格列美脲片与格列美脲片治疗2型糖尿病的疗效与安全性对照研究[J].重庆医学,2018,47(7):915-918.
[12]李伟,刘雪梅,王巧云.吡格列酮治疗脂肪肝伴2型糖尿病的代谢指标变化及肝功能观察[J].现代消化及介入诊疗,2016,21(6):843-845.
[13]张丹丹,孙娜,房辉,等.甘精胰岛素注射液联合格列美脲片治疗2型糖尿病的临床研究[J].中国临床药理学杂志,2018,34(3):251-253.
[14]吴艳霞,吴婷玉,李秀娟,等.吡格列酮对老年原发性高血压伴糖耐量异常患者动态脉压指数的影响[J].临床心血管病杂志,2013,29(6):443-445.
[15]Phielix E,Brehm A,Bernroider E,et al.Effects of pioglitazone versus glimepiride exposure on hepatocellular fat content in type2 diabetes[J].Diabetes Obes Metab,2013,15(10):915-922.
[16]McCurley JL,Fortmann AL,Gutierrez AP,et al.Pilot Test of a Culturally Appropriate Diabetes Prevention Intervention for AtRisk Latina Women[J].Diabetes Educ,2017,43(6):631-640.
[2]Arévalo-Lorido JC,Gómez JC,Huelgas RG,et al.Lowering Blood Pressure with the Combination of a Sodium-Glucose Cotransporter 2 Inhibitor and a Glucagon-like Peptide-1 Receptor Agonist in Type 2 Diabetic Patients:A Clinical Evidence[J].High Blood Press Cardiovasc Prev,2018,25(4):417-420.
[3]巴俊强,高洪蛟,许祥林,等.运动性高血压与2型糖尿病及胰岛素抵抗的相关性研究[J].第三军医大学学报,2016,38(20):2279-2282.
[4]Zhang HW,Zhao X,Guo YL,et al.Elevated lipoprotein(a)levels are associated with the presence and severity of coronary artery disease in patients with type 2 diabetes mellitus[J].Nutr Metab Cardiovasc Dis,2018,28(10):980-986.
[5]赵静,刘进娜,王帮众,等.2型糖尿病并发高血病的相关机制研究及中药复方的干预作用实验研究[J].中华中医药杂志,2016,31(9):3703-3706.
[6]李英昭,郭向阳,尹洪涛,等.西格列汀对需要大剂量胰岛素治疗的老年T2DM患者胰岛素抵抗及血糖波动的影响[J].重庆医学,2017,46(32):34-38.
[7]Young LH,Viscoli CM,Schwartz GG,et al.Heart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone[J].Circulation,2018,138(12):1210-1220.
[8]张四青,习燕华,钟树妹,等.格列美脲联合二甲双胍对新诊断2型糖尿病伴非酒精性脂肪肝病患者胰岛素抵抗和胰岛β细胞功能的影响[J].中国全科医学,2016,19(5):525-528.
[9]Martin R,Julio R,Robert AK,et al.Empagliflozin compared with glimepiride in metformin-treated patients with type 2 diabetes:208-week data from a masked randomized controlled trial[J].Diabetes Obes Metab,2018,20(12):2768-2777.
[10]陈芳,卢岚敏,韩白玉,等.2型糖尿病体重变化与心血管疾病关系[J].中国糖尿病杂志,2017,25(2):185-188.
[11]蒲丹岚,尹经霞,谢洁,等.复方盐酸吡格列酮格列美脲片与格列美脲片治疗2型糖尿病的疗效与安全性对照研究[J].重庆医学,2018,47(7):915-918.
[12]李伟,刘雪梅,王巧云.吡格列酮治疗脂肪肝伴2型糖尿病的代谢指标变化及肝功能观察[J].现代消化及介入诊疗,2016,21(6):843-845.
[13]张丹丹,孙娜,房辉,等.甘精胰岛素注射液联合格列美脲片治疗2型糖尿病的临床研究[J].中国临床药理学杂志,2018,34(3):251-253.
[14]吴艳霞,吴婷玉,李秀娟,等.吡格列酮对老年原发性高血压伴糖耐量异常患者动态脉压指数的影响[J].临床心血管病杂志,2013,29(6):443-445.
[15]Phielix E,Brehm A,Bernroider E,et al.Effects of pioglitazone versus glimepiride exposure on hepatocellular fat content in type2 diabetes[J].Diabetes Obes Metab,2013,15(10):915-922.
[16]McCurley JL,Fortmann AL,Gutierrez AP,et al.Pilot Test of a Culturally Appropriate Diabetes Prevention Intervention for AtRisk Latina Women[J].Diabetes Educ,2017,43(6):631-640.