内科

目的探讨二甲双胍联合依那普利叶酸片治疗高血压伴糖耐量减低患者的临床效果。方法选取2015年1月至2018年3月我院内分泌科收治的高血压伴糖耐量减低患者68例作为研究对象，采用随机数字表法分为观察组和对照组，每组34例。对照组患者给予马来酸依那普利叶酸片治疗，观察组患者在对照组治疗的基础上，给予盐酸二甲双胍片治疗。两组患者均连续治疗24周。比较两组患者治疗前后的血糖、胰岛素、血脂、血压水平及降血压临床疗效。结果治疗前,两组患者的血糖、胰岛素、血脂、血压水平比较差异无统计学意义（P＞0.05）。治疗24周后，两组患者的空腹血糖（FPG）、餐后2h血糖（2hPG）、餐后2h胰岛素、总胆固醇（TC）、三酰甘油（TG）、收缩压（SBP）、舒张压（DBP）水平均显著下降，胰岛素敏感指数均显著上升；观察组患者的FPG、2hPG、餐后2h胰岛素、TC、TG、SBP、DBP水平显著低于对照组，胰岛素敏感指数高于对照组；观察组患者降血压治疗总有效率（97.06%）显著高于对照组（85.29%），差异有统计学意义（P＜0.05）。结论二甲双胍与依那普利叶酸片联合治疗高血压伴糖耐量减低患者临床效果显著，能够有效降低患者血压、血糖、血脂以及餐后2h胰岛素水平，提高机体组织对胰岛素的敏感性。

ObjectiveTo investigate the clinical effects of metformin combined with enalapril folic acid tablets for patients with hypertension and impaired glucose tolerance. Methods68 patients with hypertension and impaired glucose tolerance who were admitted to the department of Endocrinology in our hospital from January 2015 to March 2018 were selected and randomly divided into the observation group and the control group, with 34 cases in each group. The patients in the control group were treated with enalapril maleate and folic acid tablets, and the patients in the observation group were treated with metformin hydrochloride on the treatment of the control group. Both groups were treated continuously for 24 weeks. The blood glucose, insulin, blood lipids, blood pressure and blood pressure reduction clinical effects before and after treatment were compared between the two groups. ResultsBefore treatment, there was no significant difference in blood glucose, insulin, blood lipids and blood pressure between the two groups (P＞0.05). After 24 weeks of treatment, the levels of fasting blood glucose (FPG), postprandial 2 h blood glucose (2 hPG), postprandal 2h insulin, total cholesterol (TC), triglyceride (TG), systolic blood pressure (SBP), and diastolic blood pressure ( DBP) decreased significantly, and insulin sensitivity index increased significantly in the two groups. The levels of FPG, 2hPG, postprandal 2h insulin, TC, TG, SBP and DBP in the observation group were significantly lower than those in the control group, and the insulin sensitivity index was higher in the observation group than that in the control group. The total effective rate of treatment of the patients in the observation group (97.06%) was significantly higher than that of the control group (85.29%), and the difference was statistically significant (P＜0.05). ConclusionMetformin combined with enalapril folic acid tablets for patients with hypertension and impaired glucose tolerance in clinical effects is significant, can effectively reduce blood pressure, blood glucose, blood lipids and postprandial 2 h blood glucose, improve the sensitivity of body tissues to insulin.