替米沙坦对老年高血压伴代谢综合征患者糖代谢的改善作用  

Effect of Telmisartan on Glucose Metabolism in Aged Hypertensive Patients with Metabolic Syndrome

作　　者：陶红[1] 米树华[1] 赵怡[1] 杨红霞[1] 苏工[1] 郑虹[1] 王曦之[1] 周芸[1] 李菁[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,北京市100029

出　　处：《中国全科医学》2010年第11期1170-1173,共4页Chinese General Practice

基　　金：北京市保健专项资金科研课题(京06-10号)

摘　　要：目的探讨替米沙坦对老年高血压伴代谢综合征患者糖代谢的影响。方法选择70例老年轻中度高血压伴代谢综合征患者,将其随机分配至替米沙坦组和硝苯地平组,各35例。替米沙坦组给予替米沙坦40 mg/d治疗,硝苯地平组给予硝苯地平30 mg/d治疗,服药6个月。比较治疗前后两组患者的糖脂代谢指标的变化。结果两组患者血压均控制良好,治疗前后收缩压及舒张压间差异均无统计学意义(P>0.05)。替米沙坦组治疗前后空腹胰岛素〔(10.4±4.4)μU/ml与(6.8±2.3)μU/ml,P<0.01〕及餐后2 h血糖水平〔(8.7±1.3)mmol/L与(7.1±0.9)mmol/L,P<0.01〕显著下降,HOMA-IR亦显著下降〔(2.5±1.2)与(1.7±0.7),P<0.01〕,早期胰岛素分泌功能指数(△I30/△G30)显著升高〔(10.4±1.9)与(15.7±2.9),P<0.01〕;治疗后上述指标与硝苯地平组比较,差异均有统计学意义(P<0.01)。硝苯地平组治疗前后各糖脂代谢指标均无显著变化。结论替米沙坦在良好降压的同时,可改善老年高血压伴代谢综合征患者的胰岛素敏感性和早期胰岛素分泌功能。Objective To investigate the effect of telmisartan on glucose metabolism in aged hypertensive patients with metabolic syndrome. Methods Seventy aged patients with mild or moderate hypertension complicated by metabolic syndrome were divided randomly into groups T （telmisartan） and N （nifedipine）, 35 in each. T group were treated with telmisartan （40 mg/d）, and N group with nifedipine （30 mg/d）, 6 months. The changes of glucose and lipid metabolism were compared between pre - and post - treatments. Results Blood pressure was well controlled in 2 groups, the difference in systolic and diastolic blood pressure was not significant between pre - and post - treatments （ P 〉 0. 05 ）. In T group, pre - and post - treatment fasting insulin （10.4 ±4.4 μU/ml, 6. 8 ± 2. 3 μU/ml, respectively）, postprandial 2 h blood glucose （8.7± 1.3 mmol/L, 7.1 ±0. 9 mmoL/L, respectively） and HOMA - IR （2. 5 ± 1.2, 1.7 ± 0.7, respectively） decreased significantly （ P 〈 0. 01 ）, and early insulinogenic index （ △I30/△G30 ） increased significantly （ 10. 4 ± 1.9, 15.7 ± 2.9, respectively） （ P 〈 0. 01 ） ; There was significant difference in the above parameters between 2 group after treatment （ P 〈 0. 01 ）. No obvious changes were noted in pre - and post - treatment glucose and lipid metabolism in N group. Conclusion Telmisartan can not only decrease blood pressure but also improve insulin sensitivity and early insulin secretion function in aged patients with hypertension complicated by metabolic syndrome.

关 键 词：替米沙坦 高血压 代谢综合征 胰岛素抵抗 老年人 

分 类 号：R544.1[医药卫生—心血管疾病] R349.14[医药卫生—内科学]