高血压药对糖尿病肾病血液透析患者代谢的影响

A comparative study of the effects of different antihypertension drugs to material metabolism of Type 2 Diabetic hemodialysis patients

目的比较血管紧张素转换酶抑制剂（ACEI）、钙离子拮抗剂（CCB）和β-受体阻滞剂等抗高血压药对糖尿病肾病及高血压透析患者的血糖和代谢的影响。方法糖尿病肾病血液透析患者分别经福辛普利（Fosinopril）、维拉帕米（Verapamil）和普萘洛尔（Propranol01）治疗5个月后记录透析前后心率和血压改变，检测透析前空腹血糖、糖化血红蛋白（HbA1c）、果糖胺、胰岛素、胆固醇和甘油三脂等。结果Fosinopril、Verapamil对血糖及物质代谢无不良影响，Propranolol可引起血糖、果糖胺、HbA1c和甘油三脂升高及透析过程中低血压和心率减慢。结论Fosinopril、Verapamil和Propranolol均为控制糖尿病肾病透析患者轻、中度高血压的较可靠药物，且Fosinopril和Verapamil对糖尿病患者血糖和物质代谢无不良影响。

Objective To compare the effects of antihypertension drugs, such as ACEI, CCB and beta blockers on the material metabolism of hemodialysis patients with T2DM and hypertension. Method After treatments with Fosinopril, Verapamil and Propranolol respectively, The changes of heart rate and blood pressure were recorded before and after hemodialysis; the changes of plasma glucose, hemoglobin A1C, fructosamin, serum insulin, cholesterol and triglycerides were compared as well. Results Fosinopril, Verapamil showed no harmful effects on plasma glucose and metabolism; while Propranolol resultel an increase of plasma glucose, fructosamin, hemoglobin A1C and triglyceride, and decrease of blood pressure and slower of heart rate during the hemodialysis. Conclusions For the hemodialysis patients with T2DM, Fosinopril, Verapamil and Propranolol are reliable drugs to control mild and moderate hypertension. Furthermore, Fosinopril and Verapamil have no bad effect to the plasma glucose and material metabolism.