Leowski J, Czech A, Gadomska M, Lastowiecki P, Laz R, Tatoń L
Katedry i Klinik Chorób Wewnetrznych i Diabetologii AM, Szpital Bródnowski w Warszawie.
Pol Tyg Lek. 1990;45(6-7):117-22.
Selection of indications and the general tactics of nifedipine monotherapy of hypertension in diabetic subjects is not clearly established, as yet. It refers specifically to different forms and phases of diabetes mellitus. This was the reason to carry out a respective study. In 4 groups of hypertension: 1) in diabetics without vascular complications, 2) in diabetic nephropathy, 3) in diabetics type II without nephropathy, and 4) in comparative group of subjects without diabetes mellitus, a 6-week controlled, open trial was performed. Before, during and after nifedipine (3 X 10-20 mg p.d.), the following parameters were monitored: 1) systolic, diastolic and mean blood pressures, 2) glycaemic indices of diabetes control, 3) serum cholesterol: total, HDL, LDL, triglycerides, 4) daily albuminuria and GFR, 5) adverse reactions to nifedipine. It could be concluded that nifedipine therapy was relatively most effective and safe in hypertensive diabetics type II without nephropathy. It was less effective in diabetics type I without nephropathy and failed in diabetics type I with nephropathy.
目前,糖尿病患者高血压硝苯地平单一疗法的适应症选择和总体策略尚未明确确立。这尤其涉及糖尿病的不同形式和阶段。这就是开展相应研究的原因。在4组高血压患者中:1)无血管并发症的糖尿病患者,2)糖尿病肾病患者,3)无肾病的II型糖尿病患者,4)无糖尿病的对照组,进行了为期6周的对照开放试验。在服用硝苯地平(每日3×10 - 20毫克)之前、期间和之后,监测以下参数:1)收缩压、舒张压和平均血压,2)糖尿病控制的血糖指标,3)血清胆固醇:总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯,4)每日蛋白尿和肾小球滤过率,5)对硝苯地平的不良反应。可以得出结论,硝苯地平疗法对无肾病的II型高血压糖尿病患者相对最有效且安全。对无肾病的I型糖尿病患者效果较差,对有肾病的I型糖尿病患者则无效。