缬沙坦与卡托普利改善高血压胰岛素抵抗的比较研究  

Comparison of effects of Yalsartan and Captopril on insulin resistance in essential hypertension

作　　者：潘海燕[1] 朱健华[1] 顾勇[1] 

机构地区：[1]南通医学院附属医院心内科,226001

出　　处：《国外医学（心血管疾病分册）》2002年第4期237-239,共3页

摘　　要：目的:观察缬沙坦(代文)及卡托普利(开博通)对高血压胰岛素抵抗(ISR)的影响。方法:将54例伴有空腹胰岛素增高的轻中度高血压病患者随机分为两组。缬沙坦治疗组(Ⅴ组):26例,每日服缬沙坦1次,80～160mg;卡托普利治疗组(C组):28例,每日服卡托普利2次,每次25～50mgo疗程为3个月。测定治疗前后血压、空腹及餐后2h血糖和胰岛素,计算胰岛素敏感指数(ISI),治疗前后比较,并设正常对照组,进行组间比较。结果:两组降压作用相似,治疗前各组空腹血糖无显著差异,两组餐后2h血糖、空腹及餐后2h胰岛素显著升高(P<0.01),ISI显著降低(P<0.01),治疗后以上指标显著改善(P<0.05),但均未达正常(P<0.05)。结论:缬沙坦和卡托普利都能改善高血压胰岛素抵抗,但短期治疗不能使胰岛素敏感性恢复正常。To compare the effects of valsartan and captopril on insulin resistance in essential hypertension. Methods: 54 mild to moderate hypertensive patients with fasting hyperinsulinemia were randomly assigned into two groups receiving either valsartan (Group V; Diovan 80-160mg qd, n =26) or captopril (Group C: Captopril 25-50mg bid, n =28) for 3 months. Blood pressure, serum concentration of fasting insulin (FINS) and glucose (FGLU), 2 hour postprandial blood gluscose and serum insulin (2hGLU and 2hINS) were measured respectively on the first and last day of treatment. 20 healthy subjects were served as a normal controlled group (Group N). Insulin-sensitivity index (ISI) was calculated to evaluate the change of ISR after treatment. ISI was also used to compare the differences of ISR among Group V, Group C and Group N. Results: There was similar efficacy in decreasing blood pressure for valsartan and captopril. There were no significant differences of FGLU among all groups before treatment. In both Group V and Group C 2hGLU, FINS and 2hINS all significantly increased while ISI significantly decreased (P<0.01). These parameters all significantly improved after treatment (P<0.05), but still did not reach normal level (P <0.05). Conclusions; Both valsartan and captopril can improve insulin sensitivity in essential hypertension. But they can not restore it to the normal level with short-term treatment.

关 键 词：缬沙坦 卡托普利 高血压 胰岛素抵抗 治疗 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]