二甲双胍对肥胖的原发性高血压伴糖耐量减低患者血压的影响  

Effect of metformin on blood pressure in obesity primary hypertension with impaired glucose tolerance

作　　者：吴胜华[1] 张春玲[1] 陈景海[2] 林中[1] 王军[3] 季晓君[3] 赵汤艳[4] 王小青[5] 

机构地区：[1]温州市第二人民医院药剂科,浙江温州325000 [2]温州市第二人民医院内分泌科,浙江温州325000 [3]温州市第二人民医院心血管科,浙江温州325000 [4]温州市第二人民医院心功能室,浙江温州325000 [5]温州市第二人民医院检验科,浙江温州325000

出　　处：《中国临床药理学杂志》2012年第1期16-19,共4页The Chinese Journal of Clinical Pharmacology

基　　金：温州市科技局课题基金资助项目(Y20100335)

摘　　要：目的评价二甲双胍对肥胖的原发性高血压伴糖耐量减低患者血压的影响。方法经糖耐量及胰岛素释放试验,筛选出肥胖的轻度原发性高血压伴糖耐量减低患者100例,口服降压药雷米普利片5 mg,每天1次;1月后,血压仍间断波动者,随机分为对照组与治疗组(各50例),2组原用降压药与原生活方式均不变;此外,治疗组加用二甲双胍片0.5 g,每日3次;疗程各16周。测定治疗前后24 h的动态血压、身高、体重、空腹血糖、血胰岛素、糖负荷后2 h血糖、血胰岛素。结果治疗后,二甲双胍组与治疗前比较或与对照组比较,平均收缩压和舒张压均明显降低(P<0.05),降压总有效率达72%,明显优于对照组44%,且2组比较有统计学意义(P<0.05);同时,餐后2 h血糖与空腹、餐后2h血胰岛素均明显下降(P<0.05);胰岛素敏感指数升高,胰岛素抵抗指数下降;体重指数明显下降(均P<0.05)。二甲双胍组无低血糖出现。结论二甲双胍对肥胖原发性高血压伴糖耐量减低患者显示了良好的抗高血压效能,且安全性较好。Objective To evaluate the efficacy of metformin on blood pressure in obesity primary hypertation patients with impaired glucose tolerance.Methods One hundred senile primary hypertation patients with impaired glucose tolerance who were not reached ideal blood pressure one month after ramipril（5 mg qd） treatment were randomized to metformin group（50 cases） and control group（50 cases）.Both groups continued old lifestyle and medication.Metformin group used metformin（0.5 g tid） for 16 weeks.Before and after 16 weeks treatment 24 hours ambulatory blood pressure monitoring,height,weight,fasting and 2 hours postprandial plasma glucose,fasting and 2 hours postprandial plasma insulin were tested.Results Compared with those in control group and themselves before metformin treatment,there were significant decreases in 24 h mean systolic and diastolic blood pressure（P0.05）,body mass index（BMI） and 2 hours postprandial plasma glucose（P0.05） and fasting and 2 hours postprandial plasma insulin（P0.05）.The rate of efficiency on blood pressure in metformin group was 72%,it was higher than in control group（44%,P0.05）.Meanwhile insulin sensitivity index（ISI） improved and insulin resistances index decreased significantly（P0.05）,respectivetly.No one showed low plasma glucose reaction in metformin group.Conclusion Metformin showed good antihypertensive efficacy and safety in obesity primary hypertention patients with impaired glucose tolerance.

关 键 词：二甲双胍 肥胖 原发性高血压 糖耐量减低 

分 类 号：R589.2[医药卫生—内分泌] R544.1[医药卫生—内科学]