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目的 了解硫氮酮缓释剂与苯那普利联合治疗 2型糖尿病轻中度高血压的疗效 ;每日 1次服药对 2 4 h动态血压 ( ABPM)和心率变异性 ( HRV)的影响 ;并与吲哒帕胺的疗效进行比较。方法 6 0例轻、中度 2型糖尿病高血压患者被随机分为两组 ,一组每日 1次口服硫氮酮缓释剂 90～ 180 mg+苯那普利 10 mg;另一组每日口服吲哒帕胺 2 .5～ 5 .0 m g+苯那普利 10 m g ,均治疗三个月 ,并于服药前及用药三个月末分别用 2 4 h ABPM和 Holter监测用药前后 ABPM和谷 /峰比值 ( T/ P)、HRV的变化情况。结果 硫氮酮缓释剂组降低收缩压 2 7.8m m Hg( P<0 .0 0 1) ,舒张压 18.5 mm Hg( P<0 .0 0 1) ,T/ P比值分别为 0 .6 4 ,总有效率 89.3%。平均降低偶测心率每分钟 5次( P=NS)。用药前后 HRV比较 :1全部正常窦性心搏间期的标准差 ( SDNN)增加 15 .2 ms( P<0 .0 1) ,2相邻 R- R间期差的均方根值 ( rm SSD)增加 7.84 m s( P<0 .0 1) ,3NN5 0除以总的 NN间期个数 ( p NN5 0 )增加 6 .12 ( P<0 .0 0 1)。吲哒帕胺组降低收缩压 2 5 .9mm Hg( P<0 .0 0 1) ,舒张压 16 .9mm Hg( P<0 .0 0 1) ,T/ P比值分别为 0 .6 6 ,总有效率 85 .7%。但对偶测心率无影响 ,用药前后比较 SDNN增加 2 .8ms( P>0 .0 5 ) ,rm SSD增加 2 .0 3m s
Objective To investigate the curative effect of combination of sustained-release thiazolidinone and benazepril on type 2 diabetes mellitus and mild to moderate hypertension. The effect of once-daily administration on 24-hour ambulatory blood pressure (ABPM) and heart rate variability (HRV) ; And compared with the efficacy of indapamide. Methods Sixty patients with mild and moderate type 2 diabetes mellitus were randomly divided into two groups. One group received once daily oral administration of diazinonide sustained-release agent 90-180 mg and benazepril 10 mg. The other group Day oral indapamide 2.5-5.0 mg + benazepril 10 mg, were treated for three months, and before the end of medication and the end of three months were 24 h ABPM and Holter monitoring before and after treatment ABPM and Valley / peak ratio (T / P), HRV changes. Results Compared with the control group, the diazoxide sustained-release agent reduced the systolic pressure by 7.87 mm Hg (P <0.001) and diastolic pressure by 18.5 mm Hg (P <0.01), and the T / P ratios were 0.6 4, the total efficiency of 89.3%. On average, heart rate was decreased 5 times per minute (P = NS). HRV comparison before and after treatment: 1 The standard deviation (SDNN) of all normal sinus beats increased by 15.2 ms (P <0.01), the root mean square (rm SSD) of 2 adjacent R- Increasing 7.84 ms (P <0.01), 3NN50 divided by the total number of NN intervals (p NN50) increased by 6.12 (P <0.001). The indapamide group reduced systolic blood pressure by 2.59 mm Hg (P <0.001) and diastolic blood pressure by 16.9 mm Hg (P <0.01) with the T / P ratios of 0.666, The total effective rate of 85.7%. But had no effect on the measured heart rate, before and after treatment compared with SDNN increased by 2. 8ms (P> 0.05), rm SSD increased 2.03m s