摘要
对20例高血压病(EH)患者拉西地平治疗前及治疗4周后,分别进行口服葡萄糖耐量试验(OGTT).并测定治疗前后血糖(SG)、血胰岛素(IS),与18例正常人(其年龄、体重指数相当)比较,结果:(1)降压作用:EH 组拉西地平治疗后血压较治疗前有显著降低(SBp:18.76±1.74kPa 比22.72±1.35kPa、DBp:11.76±1.23kPa 比14.31±1.14kPa)(P<0.05),总有效率达95%;(2)对 SG 影响:空腹血糖 EH 组较对照组无明显变化(P>0.05),OGTT 后 EH 组出现糖耐量异常达65%,治疗后血糖较治疗前略有下降,但无统计学差异;(3)对 IS 影响:EH 组血IS 空腹及 OGTT 后水平较对照组明显增高(P<0.05),IS/SG 比值空腹及 OGTT 后较对照组明显增高(P<0.05),IS 敏感性较对照组下降(0.11±0.03比0.19±0.03),EH 组拉西地平治疗后 IS 较治疗前下降。以0.5～1h 明显(0.5h:57.07±12.24mu/L 比77.26±14.49mu/L;1h:68.55±13.79mu/L 比90.09±15.25mu/L),(P<0.05),IS 敏感性较治疗前增加(0.14±0.06比0.11±0.03)。提示:EH 患者存在高胰岛素血症;拉西地平降压同时也降低了血 IS,增加了 IS 敏感性,使胰岛素抵抗得到了改善。
An oral glucose tolerance test(OGTT)was performed in 20 patients with essential hyperten- son(EH),campared with 18 Normal subjects.The results showed the blood pressure of EH group was significantly decreased after the treatmant with Lacidipine(P<0.05),with a total effective rate of 95%;with the abnormal glucose tolerance of 65% in EH group after the OGTT,and the SG was slightly decreased with no significant difference after and befor the treatment,and that the fasting and OGTT plasma insulin levers were higher in EH group than those in normal group (P<0.05),and the IS to SG ratio was obviously increased both in fasting and OGTT(P<0.05), with the lower IS sensibility than normal control.In the EH group,the IS was decreased especially 0.5 to 1 hour after the treatment with Lacidipine(P<0.05)with the IS sensibility increased. There for it is sugested that there may appere hyperinsulinemia in patients with EH and that Lacidipine decreases not only the blood pressure but also the plasma IS and increases the IS sensi- bility to improve hyperinsulinemia.
