羅格列酮治療原發性高血壓合并2型糖尿病臨床評價

[摘要] 目的探討羅格列酮治療原發性高血壓合并2型糖尿病的降壓效果。方法將200例病人隨機分為羅格列酮聯合治療(治療組)100例和常規治療(對照組)100例，觀察兩組的臨床療效及治療前和治療后2～12周血壓變化。結果 治療組總有效92例(92.0%)，顯著高于對照組72例(72.0%)(u=2.99，P<0.05);治療組治療后第12周收縮壓[(16.08±1.68)kPa]、舒張壓[(10.09±1.61)kPa]明顯低于治療前[(20.73±0.70)kPa、(13.71±0.84)kPa](t=3.01，t=4.05，P均<0.01);對照組治療后第12周收縮壓[(17.74±2.86)kPa]、舒張壓[(10.92±1.61)kPa]明顯低于治療前[(20.73±0.70)kPa、(13.67±0.81)kPa](t=3.05，t=3.15，P<0.01);治療組2～10周收縮壓、舒張壓較對照組比較下降明顯(t=1.98～2.64，P均<0.05);兩組收縮壓和舒張壓第8周后血壓處于較平穩狀態。結論羅格列酮對原發性高血壓有良好的降壓作用，且安全性較好。

[關鍵詞] 高血壓; 糖尿病; 羅格列酮; 降壓

[中圖分類號] R587.2 [文獻標識碼] A [文章編號] 1673-9701(2010)05-13-03

Treatment of Essential Hypertension with Type 2 Diabetes with Rosiglitazone:Clinical Evaluation

LIAO Weidong1 LI Guiping2 CHEN Lifen1

1.Department of Pharmacology，2.Department of Medicine with Cardiovascular and Nephrology，Huizhou City Third People's Hospital，Huizhou 516002，China

[Abstract] ObjectiveTo investigate the curative effect of rosiglitazone on essential hypertension with type 2 diabetes. MethodsWe divided 200 cases of essential hypertension with type 2 diabetes randomly into Rosiglitazone combination therapy(treatment group，100 cases)and conventional therapy(control group 100 cases). The curative effect and blood pressure changes before treatment and at 2 to 12 weeks after treatment were observed. ResultsThe total effective rate was 92.0%(92 cases)in the treatment group，significantly higher than that in(72 cases，72.0%)in the control group(u=2.99，P<0.05). The systolic blood pressure(16.08±1.68)kPa and diastolic pressure(10.09±1.61)kPa in the treatment group at 12 weeks after treatment，significantly lower than those before treatment[(20.73±0.70)kPa，(13.71±0.84)kPa](t=3.01，t=4.05，P<0.01).The systolic blood pressure(17.74±2.86)kPa and diastolic pressure(10.92±1.61)kPa in the control group at 12 weeks after treatment were significantly lower than those before treatment[(20.73±0.70)kPa，(13.67±0.81)kPa(t=3.05，t=3.05，P<0.01).The systolic pressure and diastolic blood pressure in both groups after 8 weeks were relatively stable. ConclusionRosiglitazone have a good and safe effect in the treatment of essential hypertension with type 2 diabetes.

[Key words]Hypertension; Diabetes; Rosiglitazone; Hypotension

高血壓病合并糖尿病時的血壓常難以控制，增加病人服藥的種類及經濟負擔，因此尋找一種對兩種疾病均有治療作用的藥物具有非常重要的臨床意義。而胰島素增敏劑-羅格列酮具有此種治療作用[1]，筆者就羅格列酮對高血壓病合并2型糖尿病的降壓效果進行觀察，并報道如下。

1 資料與方法

1.1 臨床病例

選取2004年1月～2008年1月在我院門診及住院的病人200例(男115例，女85例)，平均年齡(56±5)歲;高血壓病程4～12年，糖尿病病程3～9年。高血壓標準均符合1999年WHO高血壓專家委員會規定的診斷標準[即SBP≥19kPa和(或)DBP≥12kPa]，糖尿病診斷均符合1999年WHO規定的診斷標準(空腹血糖≥7.0mmol/L)。排除標準:繼發性、惡性及急進性高血壓患者;嚴重心腦血管并發癥;有明顯肝腎功能異常;糖尿病;對羅格列酮過敏者;妊娠、哺乳期婦女及其他不適宜者。……