CAJ | 학술논문

目的：观察氨氯地平联合坎地沙坦治疗高血压伴糖尿病63例临床疗效。方法选取2009年2月至2012年10月来新疆军区机关门诊部和新疆维吾尔自治区人民医院心内科就诊的126例高血压伴糖尿病蛋白尿患者，所有患者签署知情同意书，并经医院伦理委员会批准，按数字表法随机分成对照组和联合组，每组63例。2组均给予常规降糖治疗，对照组给予氨氯地平5 mg，1次/d；治疗组在此基础上加服坎地沙坦8 mg，1次/d，如1周后血压仍≥140/90 mmHg则坎地沙坦加至8 mg，2次/d，疗程均为6个月。观察2组患者治疗后血压、空腹血糖、血肌酐、尿素氮以及24 h尿蛋白的变化。结果2组患者经治疗后，血压较治疗前均显著降低（P＜0．05），联合组下降更明显（P＜0．05）；2组血肌酐、尿素氮及24 h尿蛋白较治疗前均有降低，且联合组明显低于对照组（P＜0．05）。结论氨氯地平联合坎地沙坦不仅能有效控制血压，且可降低高血压伴糖尿病患者血肌酐、尿素氮及尿蛋白水平，能更有效保护肾功能。
목적：관찰안록지평연합감지사탄치료고혈압반당뇨병63례림상료효。방법선취2009년2월지2012년10월래신강군구궤관문진부화신강유오이자치구인민의원심내과취진적126례고혈압반당뇨병단백뇨환자，소유환자첨서지정동의서，병경의원윤리위원회비준，안수자표법수궤분성대조조화연합조，매조63례。2조균급여상규강당치료，대조조급여안록지평5 mg，1차/d；치료조재차기출상가복감지사탄8 mg，1차/d，여1주후혈압잉≥140/90 mmHg칙감지사탄가지8 mg，2차/d，료정균위6개월。관찰2조환자치료후혈압、공복혈당、혈기항、뇨소담이급24 h뇨단백적변화。결과2조환자경치료후，혈압교치료전균현저강저（P＜0．05），연합조하강경명현（P＜0．05）；2조혈기항、뇨소담급24 h뇨단백교치료전균유강저，차연합조명현저우대조조（P＜0．05）。결론안록지평연합감지사탄불부능유효공제혈압，차가강저고혈압반당뇨병환자혈기항、뇨소담급뇨단백수평，능경유효보호신공능。
Objective To observe the effects of amlodipine combined with candesartan on the patients with hypertension and diabetes.Methods One hundred and twenty-six cases of hypertension complicated with diabetes from the medical data in the Clinic of the Xinjiang Military Command and the Cardiology Department of the Xinjiang Uygur Autonomous Region from Febru-ary 2009 to October 2012 were chosen as our study subjects.With the knowledge and consent of the patients and following approv-al by the Hospital Ethics Committee, the patients were randomly divided into the control group and the combined treatment group, each consisting 63 patients.The patients in both groups were all given routine drugs for the control of glycemia, while the patients in the control group received amlodipine with a dosage of 5 mg, once a day.The patients in the combined treatment group were given candesartan with a dosage of 8mg, once a day, in addition to routine drugs.If the blood pressure of the patients was still higher than 140/90 mmHg following 1 week of treatment, the application of candesartan was increased to twice a day also at a dos-age of 8mg.The treatment course for the patients of both groups was all 6 months.Observations were made on the changes in blood pressure, fasting glucose, serum creatine, urinary nitrogen and 24-hour urinary protein.Results The blood pressure of the patients in both groups was all significantly decreased after treatment (P <0.05), with the blood pressure of the patients in the combined treatment group decreased more significantly ( P <0.05) .The levels of serum creatine, urinary nitrogen and 24-hour urinary protein in the patients of both groups were all decreased, when compared with those before treatment, and they were signif-icantly lower than those of the control group ( P <0 .05 ) .Conclusion Treatment with amlodipine combined with candesartan could not only control blood pressure effectively, but reduce serum creatine, urinary nitrogen and 24-hour urinary protein in pa-tients with hypertension complicated with diabetes.Furthermore, the combined treatment was obviously more beneficial to the re-nal function of those affected patients.