Tatarchenko I P, Pozdniakova N V, Mordovina A G, Sekerko S A, Morozova O I
Klin Med (Mosk). 2009;87(10):20-4.
The study was designed to evaluate effect of enalapril and telmisartan on hemodynamic characteristics and diastolic function (DF) of left ventricle (LV) in patients with type 2 diabetes and arterial hypertension (AH). It included 64 patients aged 54.3 +/- 5.2 years. Those in group 1 (n = 31) were given enalapril (enap), patients of group 2 (n = 33) were treated with telmisartan (micardis). Examination included 24 hour AP monitoring, Holter ECG monitoring, and echocardiography. Compensation of metabolic disorders was evaluated from fasting and postprandial blood glucose and HbAc1 levels. Impaired LV DF was the main feature of affected myocardium in patients with DM2 and elevated AP in the absence of contractility disturbance. Enalapril therapy ensured the desired level of systolic and diastolic AP in 77 and 64.5% of the patients respectively in association with a decreased number of non-dippers and night-peakers in 45.4% of the observations in the absence of changes in HbAc1 level and LV DF. Treatment with telmisartan ensured within 24 weeks efficacious control of systolic AP and normalization of its daily profile in 87.5% patients with pathological circadian rhythm, besides improvement of carbohydrate metabolism and LV DF.
本研究旨在评估依那普利和替米沙坦对2型糖尿病合并动脉高血压（AH）患者左心室（LV）血流动力学特征及舒张功能（DF）的影响。研究纳入了64例年龄为54.3±5.2岁的患者。第1组（n = 31）给予依那普利（enap），第2组（n = 33）给予替米沙坦（美卡素）治疗。检查包括24小时血压监测、动态心电图监测和超声心动图检查。通过空腹及餐后血糖和糖化血红蛋白（HbAc1）水平评估代谢紊乱的代偿情况。在2型糖尿病且血压升高但无收缩功能障碍的患者中，左心室舒张功能受损是受影响心肌的主要特征。依那普利治疗分别使77%和64.5%的患者达到了理想的收缩压和舒张压水平，同时在糖化血红蛋白水平和左心室舒张功能无变化的情况下，45.4%的观察对象中血压非勺型和夜间血压峰值数量减少。替米沙坦治疗在24周内确保了87.5%昼夜节律异常患者的收缩压有效控制及其每日血压曲线正常化，此外还改善了碳水化合物代谢和左心室舒张功能。
