替米沙坦降压治疗对原发性高血压患者胰岛素抵抗的影响

目的:研究替米沙坦对原发性高血压患者胰岛素抵抗的影响.方法:选择伴有胰岛素抵抗的高血压病患者128例.随机分为替米沙坦80mg/d组(A组)、氨氯地平5mg/d+吡格列酮15mg/d组(B组)及氨氯地平5mg/d组(C组).分别于治疗前及治疗12周后检测空腹血糖(FPG)、空腹胰岛素(FINS)、口服葡萄糖耐量实验(OGTT)、餐后2 h血糖(P2hBG)、餐后2 h胰岛素(P2hINS)及24 h动态血压,计算胰岛素抵抗指标(HOMA-IR).结果:用药后12周A组与B组FINS,P2hBG,P2hINS显著下降,胰岛素敏感指标(HOMA-IS)升高,HOMA-IR降低(P<0.05).治疗后A组与B组各项指标比较差异无统计学意义(P>0.05);C组治疗前后FINS,P2hBG,P2hINS,HOMA-IS及HOMA-IR无明显改善.3组治疗后血压水平均较治疗前明显下降(P<0.05),治疗后3组间血压比较差异无统计学意义(P>0.05).结论:替米沙坦在降压的同时可以明显改善胰岛素抵抗,适用于高血压合并胰岛素抵抗患者.

Effect of Antihypertension Treatment with Telmisartan on Insulin Resistance in Essential Hypertension Patients

Objective:To investigate the effect of antihypertension treatment with Telmisartan on insulin resistance in hypertension patients.Methods:128 essential hypertension patients with insulin resistance were randomly divided into three groups: A(treatment with Telmisartan 80 mg/d),B(treatment with Amlodipine 5 mg/d plus Pioglitazone 15 mg/d),C(treatment with Amlodipine 5mg/d).Period of the treament were three months.FPG,FINS,OGTT,P2hBG,P2hINS,24-hour ambulatory blood pressure were detected before and after treatment respectively.HOMA-IR was calculated.Results:FINS,P2hBG,P2hINS and HOMA-IR decreased and HOMA-IS increased rapidly after treatment in group A and B(P < 0.05,) but FINS,P2hBG,P2hINS,HOMA-IS and HOMA-IR were not improved in group C(P > 0.05.) All monitoring indexes were no significant difference among the group A and B after treatment(P > 0.05.) The blood pressure decreased sig-nificantly after treatment in three groups P < 0.05,there is no statistic significance among three groups after treatment P > 0.05.Conclusion:Telmisartan not only effectively control blood pres-sure but also improve insulin resistance in hypertension patients.