钙拮抗剂和β－受体阻滞剂的降压作用对胰岛素抵抗的影响  

Antihypertensive effects of verapamil and atenolol on insulin resistance

作　　者：周宏研[1] 郑昭芬[1] 孙明[1] 王振华[1] 

机构地区：[1]湖南医科大学附属湘雅医院心内科

出　　处：《临床心血管病杂志》1995年第4期208-210,共3页Journal of Clinical Cardiology

摘　　要：本文观察４５例轻、中度非肥胖高血压病患者口服异搏定、氨酰心安降压治疗２４周后对胰岛素抵抗的影响。结果：异搏定治疗后血浆葡萄糖浓度（ＰＧ）无变化；血浆胰岛素浓度（ＩＮＳ）下降（１３．９±３．６ｍＵ／Ｌ：１１．０±２．４ｍＵ／Ｌ，Ｐ＜０．０１）；胰岛素敏感性格数（ＩＳＩ）增加（－４．１０±０．３４：－３．９２±０．２７，Ｐ＜０．０１），表明其对胰岛素浓度有影响。氨酰心安治疗后ＰＧ升高（４．６０±０．４３ｍｍｏｌ／Ｌ：５．３８±０．４６ｍｍｏｌ／Ｌ，Ｐ＜０．００１）；ＩＮＳ下降（１４．７±４．８ｍＵ／Ｌ：１３．７±３．４ｍＵ／Ｌ，Ｐ＜０．０５）；ＩＳＩ减少（－４．１１±０．２９：１－４．２５±０．３０，Ｐ＜０．０５）．表明其加重了胰岛素抵抗。因此，对合并胰岛素抵抗的高血压病患者，应注意降压药物的选择。Abstract Firty five non-obese moderate to middle hypertensive patients were treated with verapamil or atenolol for 24 weeks.Their antihypertensive effect and effect on insulin resistence were studied.The results showed,that the antihypertensive effect was comparable in both drugs.Plasma glucose concentration(PG)was unchanged,insulin concentration(INS)was reduced(13.9±3.6 mU/L vs 11.0±2.4mU/L,P<0.01)and insulin sensitivity index(ISI)was raised(-4.10±0.34 vs-3.92±0.27.P<0.01)after 24 weeks of effectively antihypertensive treatment with verapamil.Insulin resistance became weaker by verapamil.Whereas PG were increased(4.60±0.43 mmol/L vs 5.38±0.46mmol/L,P<0.001),INS lowered(14.7±4.8mU/L vs l3.7±3.4mU/L,P<0.05)and ISI raised (-4.11±0.29 vs-4.25±0.30,P<0.05)after 24 weeks of effectively antihypertensive treatment with atenolol.Atenolol made insulin resistance worse.Therefor,when we treat the patients with essential hypertension and insulin resistance,antihypertensive agents should be choosen carefully.

关 键 词：高血压 胰岛素 异搏定 氨酰心安 钙拮抗剂 

分 类 号：R972.4[医药卫生—药品]