老年高血压病患者血清真胰岛素、C肽水平及替米沙坦的干预作用  

Serum levels of true insulin and C peptide and the intervention of telmisartan on them in the elderly with hypertension

作　　者：付军[1] 冷吉燕[1] 纪莉[1] 刘补尚[2] 

机构地区：[1]吉林大学第一医院老年病科,吉林长春130021 [2]长春市中心医院心内科

出　　处：《中国老年学杂志》2007年第24期2394-2396,共3页Chinese Journal of Gerontology

基　　金：吉林省财政厅资助课题(2006)

摘　　要：目的通过对老年高血压非糖尿病患者血清真胰岛素、C肽、血糖的观察,探讨高胰岛素血症、胰岛素抵抗(IR)与老年高血压的关系,以及替米沙坦干预的影响。方法测定20例非肥胖型老年高血压病患者(NHT组),15例肥胖型老年高血压病患者(OHT组)及20例健康老年人(对照组)的空腹血糖、真胰岛素、C肽、血脂、血尿酸和IR指数、胰岛β细胞功能指数。高血压病患者予以替米沙坦(80 mg,1次/d口服)治疗,4 w后复查,观察治疗前后血压和上述指标的变化。结果本研究的3组患者年龄、性别、空腹血糖状况相匹配。OHT组和NHT组血清真胰岛素、C肽水平及IR指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-islet)均高于健康对照组。高血压病患者经替米沙坦治疗后血压、真胰岛素、C肽水平及HOMA-IR和HOMA-islet指数较治疗前均明显下降,差异具有显著性(P<0.05)。结论老年高血压非糖尿病患者,特别是伴有肥胖者,存在IR、高胰岛素血症及代偿性胰岛β细胞功能增高。替米沙坦除了具有强效降低血压的作用外,还具有改善IR和胰岛β细胞功能的作用。Objective Through observing serum levels of true insulin, C peptide and blood glucose in the hypertension elderly to explore the relationship between hyperinsulinemia, insulin resistant （IR） and hypertension and the effect of telmisartan. Methods The fasting plasma glucose （FPG）, true insulin, C peptide, blood fat, blood uric acid, IR index and islet β cell function index were determined in 20 non-obesity hypertension elderly（ NHT group）, 15 obesity hypertension elderly（ OHT group）and 20 healthy elderly（ control group）. The hypertension patients were given orally 80 mg telmisartan once a day to observe the changes of blood pressure and the above indexes 4 weeks later. Results The age, sex and FPG in three groups were matched. The serum levels of true insulin, C peptide and HOMA-IR and HOMA islet indexes in OHT and NHT groups were higher than those in control group. The blood pressue,true insulin, C peptide and HOMA-IR and HOMA islet indexes in hypertension patients after treatment with telmisartan were significantly lower than those before treatment （ P 〈 0.05 ）. Conclusions IR, hyperinsulinemia and the increased compensative islet 13 cell function exsit in the elderly hypertension and nondiabetic patients, especially in those with obesity. Telmisartan could improve IR and islet β cell function, except effectively lower blood pressure.

关 键 词：高血压 真胰岛素 C肽 胰岛素抵抗 替米沙坦 

分 类 号：R587[医药卫生—内分泌] R592[医药卫生—内科学]