苯那普利对非胰岛素依赖性糖尿病、高血压病、糖尿病伴高血压病患者胰岛素抵抗的干预

EFFECTS OF BENAZEPRIL ON INSULIN RESISTANCE IN PATIENTS WITH NON INSULIN DEPENDENT DIABETES MELLITUS,ESSENTIAL HYPERTENSION AND NON INSULIN DEPENDENT DIABETES MELLITUS COMPLICATED WITH ESSENTIAL HYPERTENSION

目的：研究非胰岛素依赖性糖尿病（ Ｎ Ｉ Ｄ Ｄ Ｍ ）、高血压病、 Ｎ Ｉ Ｄ Ｄ Ｍ 伴高血压病患者的胰岛素抵抗及苯那普利对其的干预。方法：正常对照组、 Ｎ Ｉ Ｄ Ｄ Ｍ 组、高血压病组及 Ｎ Ｉ Ｄ Ｄ Ｍ 伴高血压病组均为 ３０ 例，均行口服葡萄糖耐量试验、测血糖、血胰岛素，除正常对照组外，其余 ３ 组服苯那普利 １０～２０ ｍ ｇ／ｄ，共 ６ 周，６周后重复上述试验，并计算空腹血胰岛素与血糖比值（ Ｉ／ Ｇ）。结果： Ｎ Ｉ Ｄ Ｄ Ｍ 组、高血压病组、 Ｎ Ｉ Ｄ Ｄ Ｍ 伴高血压病组患者血糖、血胰岛素、 Ｉ／ Ｇ 均高于正常对照组， Ｎ Ｉ Ｄ Ｄ Ｍ 组 Ｉ／ Ｇ 大于高血压病组（ Ｐ＜ ００５）； Ｎ Ｉ Ｄ Ｄ Ｍ 伴高血压病组糖负荷后 ２ ｈ 血胰岛素值高于其他两组（ Ｐ＜ ００５）；苯那普利治疗后 ３ 组患者的血糖、血胰岛素、 Ｉ／ Ｇ、糖耐量及胰岛素释放曲线下面积均较治疗前明显下降（ Ｐ＜ ００５）。结论：苯那普利能改善 Ｎ Ｉ Ｄ Ｄ Ｍ 、高血压及 Ｎ Ｉ Ｄ Ｄ Ｍ 伴高血压的胰岛素抵抗，增加周围组织对胰岛素的敏感性，改善糖代谢。

Objective:To study and compare the differences of insulin resistance(ISR)in patients with non insulin dependent diabetes mellitus(NIDDM),essential hypertension(EH) and NIDDM complicated with EH(NIDDME),and the effects of benazepril on ISR in those patients.Methods:Oral glucose tolerance test and insulin release test were studied in controls (n=30) and in patient groups with NIDDM (n=30),EH (n=30) and NIDDME(n=30) before and after taking benazepril (10～20 mg/d) for 6 weeks.Results:The blood glucose level,blood insulin level,fast blood insulin/glucose(I/G) ratio in NIDDM,EH and NIDDME were higher than those in the control group.The I/G ratio in NIDDM group was higher than that in EH group ( P <0 05).Two hour after the insulin release test,serum insulin was higher in NIDDME group than in NIDDM and EH groups ( P <0 05).In the sixth week after taking benazepril,the blood glucose,blood insulin,fast I/G ratio,the areas under glucose tolerance and insulin release curves in NIDDM,EH and NIDDME were reduced ( P <0 05).Conclusion:ISR is present in patients with NIDDM,EH and NIDDME.Benazepril can improve ISR in all patients studied.