氯沙坦对高血压病患者胰岛素敏感性的影响

Effect of Losartan on The Insulin Resistance in Essential Hypertension

目的:观察氯沙坦对高血压病(EH)患者胰岛素敏感性(ISR)的影响。方法:临床观察原发性高血压患者68例,用氯沙坦治疗5周前后分别采用无创性携带式动态血压监测仪监测动态血压,同时治疗前后分别测空腹血糖(BG)及空腹血胰岛素(IS),同时选取正常对照组52例观察胰岛素敏感性指数(ISI)。结果:①服用氯沙坦后EH患者的血压与用药前比较明显降低(P<0.01)。②治疗前EH组与正常对照组BG均正常,无显著差异。治疗前EH组IS显著高于正常对照组(P<0.01),而ISI低于对照组(P<0.01)。③治疗前后比较BG无统计学差异;治疗后较治疗前IS明显下降(P<0.01);ISI明显增高(P<0.01)。结论:高血压病患者存在胰岛素抵抗;氯沙坦在稳定降压的同时改善胰岛素敏感性。

Objective.To observe the effect of Losartan on the insulin resistance （ISR） in essential hypertension （EH）. Methods：The ambulatory blood pressure of 68 EH patients was observed by 24 - hour noninvasive ambulatory blood pressure monitoring （ABPM） 5 weeks before and after treatment with Losartan. Their levels of blood glucose （BG） and insulin （IS） were measured before and after treatment. 52 normals were selected as controis for detecting insulin sensitive index（ISI） .Results： ①The blood pressure of EH patients was significantly decreased after treatment （P 〈 0.01）. ②There was no significantly statistical difference in BG between EH group and control group. Before treatment, the level of IS in EH group was markedly higher than that in control group （P 〈 0.01）, the levelof ISI in EH group was lower than that in control group （P 〈 0.01）. ③Compared with those before treatment, the level of BG had no statistical difference, that of IS showed significantly decresing （P 〈 0.01）：, and that of ISI increasing （P 〈 0.01） after treatment. Conclusion ： The patient with EH presents ISR. Losartan plays role in decreasing blood pressure and improving ISR.