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利尿剂及其他抗高血压药物与非胰岛素依赖型糖尿病合并高血压患者的血糖控制。福冈糖尿病诊所集团的一项调查。

Diuretics and other antihypertensive drugs and glycemic control in non-insulin-dependent diabetics with hypertension. A survey by the Fukuoka Diabetes Clinic Group.

作者信息

Tsutsu N, Nunoi K, Yokomizo Y, Kikuchi M, Fukiyama K, Fujishima M

机构信息

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Clin Exp Hypertens A. 1989;11(8):1487-504. doi: 10.3109/10641968909038178.

Abstract

We compared the levels of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1) in non-insulin-dependent diabetics with hypertension who were treated with monotherapy of diuretics or other antihypertensive drugs (AHD) and in those who were not given any AHD. Total 162 patients were divided into the four groups; the control group without AHD (n = 45), the diuretics group (n = 42), the beta-blocker group (n = 30) and the Ca-antagonist group (n = 45). FPG and HbA1 levels were 153 +/- 44 mg/dl and 10.0 +/- 2.3% for the control group, 145 +/- 55 mg/dl and 9.8 +/- 2.2% for the diuretics, 165 +/- 63 mg/dl and 10.2 +/- 2.1% for the beta-blocker and 158 +/- 42 mg/dl and 10.4 +/- 2.0% for the Ca-antagonist, respectively. There were no significant differences in the levels of FPG and HbA1 among the four groups. Multivariate analysis also revealed no difference in glycemic control even when anti-diabetic treatment (diet alone, oral hypoglycemic agents or insulin), body mass index, serum potassium, systolic and diastolic blood pressures and age were taken into account. Blood pressure levels did not differ among the groups except control and they were well controlled at the low doses of AHD. Our results suggest that the choice of low dose diuretics for the treatment of hypertension in non-insulin-dependent diabetics might not be necessarily excluded by the only reason of the possible deleterious influence on glycemic control.

摘要

我们比较了接受利尿剂或其他抗高血压药物(AHD)单一疗法治疗的非胰岛素依赖型糖尿病合并高血压患者与未接受任何AHD治疗的患者的空腹血糖(FPG)和糖化血红蛋白(HbA1)水平。总共162例患者被分为四组:未接受AHD的对照组(n = 45)、利尿剂组(n = 42)、β受体阻滞剂组(n = 30)和钙拮抗剂组(n = 45)。对照组的FPG和HbA1水平分别为153±44mg/dl和10.0±2.3%,利尿剂组为145±55mg/dl和9.8±2.2%,β受体阻滞剂组为165±63mg/dl和10.2±2.1%,钙拮抗剂组为158±42mg/dl和10.4±2.0%。四组之间的FPG和HbA1水平无显著差异。多变量分析还显示,即使考虑了抗糖尿病治疗(仅饮食、口服降糖药或胰岛素)、体重指数、血清钾、收缩压和舒张压以及年龄,血糖控制方面也没有差异。除对照组外,各组血压水平无差异,且在低剂量AHD治疗下血压得到良好控制。我们的结果表明,在非胰岛素依赖型糖尿病患者中选择低剂量利尿剂治疗高血压不一定会因可能对血糖控制产生有害影响这一唯一原因而被排除。

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