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目的探讨糖尿病合并高血压治疗的临床用药。方法对WHO和国际高血压联盟1999年“高血压治疗指南”推荐的6大类一线抗高血压药物的作用机制,临床疗效及不良反应进行阐述。结果临床常用的6大类抗高血压药物品种繁多,各有利弊,选择时应根据药物的特点加以使用,注意用药个体化,对药物的不良反应及配伍禁忌等要权衡利弊,综合考虑,合理选择。结论血管紧张素转换酶抑制剂(ACEI)不影响糖代谢。通过阻断肾素-血管紧张素-醛固酮系统,能产生多种对心、肾的有益效应。尤其适用于伴有糖尿病肾病的患者,可作为糖尿病合并高血压的首选药,而不要选择β受体阻滞剂。因能影响脂质代谢,加重降糖药引起的低血糖反应,严重时甚至会影响心脏的功能。
Objective To investigate the clinical treatment of diabetes mellitus complicated with hypertension. Methods The mechanism, clinical efficacy and adverse reactions of six kinds of first-line antihypertensive drugs recommended by the WHO Hypertension Treatment Guideline 1999 and the International Hypertension Union were elaborated. Results There are many kinds of antihypertensive drugs commonly used in the 6 categories, each with its own advantages and disadvantages. It should be used according to the characteristics of the drugs when choosing it. Pay attention to the individualization of drugs, to weigh the pros and cons of adverse drug reactions and incompatibility of drugs. select. Conclusion Angiotensin-converting enzyme inhibitor (ACEI) does not affect glucose metabolism. By blocking the renin-angiotensin-aldosterone system, a variety of heart and kidney beneficial effects can be produced. Especially for patients with diabetic nephropathy, diabetes can be used as the drug of choice for hypertension, not to choose β-blockers. Because it can affect lipid metabolism, hypoglycemic drugs caused by aggravating hypoglycemic reactions, even in severe cases can affect the heart’s function.