缬沙坦在冠心病伴糖尿病患者中的应用

钟明1，黄国鸿2

(1.深圳市宝安区妇幼保健院药剂科，深圳518133；2.广州中医药大学附属宝安中医院内科，深圳518133)

摘要：目的研究缬沙坦在冠心病伴糖尿病中的应用效果。方法选择我院2012年7月至2013年9月收治的冠心病患者88例，依据是否同时合并糖尿病，将研究对象分为观察组(CD合并DM组)42例和对照组(CD组)46例，均应用缬沙坦连续治疗15 d，分别统计并对比各组患者在用药前后机体血糖指标、NO，ET-1及肱动脉内皮依赖性舒张功能[FMD%=(D1-D0)/D0% ]。结果2组在治疗后ET-1水平均下降，NO及D1-D0/D0%水平均上升，与治疗前相比,差异均有统计学意义(P<0.05)，但组间相比，上述指标差异均无统计学意义；治疗前，观察组的FBG、2hPBG及HbAlc水平显著高于对照组，治疗15 d后观察组FBG、2hPBG及HbAlc水平与治疗前相比无明显变化；治疗过程中，观察组不良反应发生率为14.29%(6/42)，对照组不良反应发生率为10.87%(5/46)，组间差异无统计学意义。结论缬沙坦对CD伴DM患者内皮功能的改善情况等同于其治疗单纯CD患者，缬沙坦不仅可有效改善CD伴DM患者内皮功能，且对病人血糖水平无负面影响。

关键词：缬沙坦；冠心病；糖尿病；内皮功能

doi:10.3969/j.issn.1004-2407.2015.03.022

中图分类号：R972

文献标志码：A

文章编号：1004-2407(2015)03-0292-04

Abstract:ObjectiveTo study the effect of valsartan in coronary heart disease(CD) patients with diabetes mellitus(DM). MethodsIn our hospital from 2012 July to 2013 September, 88 patients with coronary heart disease were selected as subjects.Based on whether they associated with diabetes，the subjects were divided into observation group (CD combined DM group) 42 cases and the control group (CD group) 46 cases. Both groups were given valsartan for 15 days.The glycemic index，NO，ET-1 and endothelial dependent vasodilation function of brachial artery (D1-D0)/D0% were measured and compared before and after the treatment. Results The two groups ET-1 levels after treatment were decreased，NO and (D1-D0)/D0% levels were increased.The difference had statistical significance (P<0.05).But compared with the index between groups，there was no significant difference；After treatment of 15 days，FBG，2hPBG and HbAlc levels of the observation group had no obvious change.The incidence of adverse reaction of the observation group was 14.29% (6/42)，the incidence of adverse reaction of the control group was 10.87% (5/46).No statistically significant difference was observed between the groups. ConclusionValsartan can effectively improve the endothelial function of CD patients with DM，and no negative effect on blood glucose level was observed.

收稿日期：(2014-10-10)

Application of valsartan in diabetes mellitus with coronary heart disease

ZHONG Ming1，HUANG Guohong2(1.Department of Pharmacy，Maternal and Child Health Hospital of Baoan in Shenzhen，Shenzhen 518133，China；2.Department of Medical，Baoan District Hospital of Chinese Medicine in Guangzhou ，Shenzhen 518133，China)

Key words: valsartan；coronary heart disease；diabetes；endothelial function

冠心病(coronary disease，CD)为冠状动脉发生动脉粥样硬化样改变后，导致冠状动脉血管腔狭窄或阻塞，使得心肌细胞由于缺血、缺氧而发生变性、坏死等病理改变的一种心血管疾病。分析其病因发现，CD发病因子为内皮功能发生紊乱[1]。因此，可通过改善CD病人内皮功能来治疗该病，而缬沙坦就是基于其对血管内皮具有的良好改善功能，而成为冠心病临床治疗的首选药物，CD伴糖尿病(diabetes mellitus，DM)患者较为多见[2]，CD伴DM患者在具有冠心病病理改变的基础上,同时伴有糖代谢异常等情况，本文对缬沙坦治疗CD、CD伴DM共88例患者的临床资料进行分析。

1资料和方法

1.1临床资料选择我院2012年7月至2013年9月收治的冠心病患者88例，均为女性， 年龄28~88岁，平均年龄66.9±12.0岁。所有患者均经上级医院进行冠脉造影检查后确诊为冠心病；……