缬沙坦与贝那普利对轻、中度原发性高血压的疗效观察及胰岛素抵抗的影响

Effects of Valsartan or Benazepril on Blood Pressure and Insulin Resistance in Patients with Mild to Moderate Essential Hypertension

目的：观察缬沙坦与贝那普利对轻、中度原发性高血压治疗的临床效果。方法t选择轻、中度原发性高血压患者87例，随机分为缬沙坦治疗组（A组）44例，贝那普利治疗组（B组）43例。A组给予缬沙坦80mg／d，B组给予贝那普利5-10mg／d，服药前和服药4周后分别检测24h动态血压（ABPM）、空腹血糖（n3G）和空腹胰岛素（FINS），计算胰岛素抵抗指数（HOM舡取）和胰岛素敏感指标（HOMA-IS）。结果：治疗4周后，两组患者血压明显下降，与治疗前相比差异有统计学意义（P〈0．05）；两组患者FINS下降，HOMA-IR下降，HOMA-IS上升，与治疗前比较差异有统计学意义（P〈0．05）；治疗后A、B两组间FINS、HOMA-IR、HOMA-IS比较无统计学差异（P均〉0．05）。结论：缬沙坦与贝那普利均有良好的降压效果，两者均可改善轻、中度原发性高血压患者的胰岛素抵抗。

Objective.To observe the clinical efficacY of valsartan and benazepril in the treatment of patients with mild to moderate essential hypertension. Methods. A total of 87 patients with mild to moderate essential hypertension were randomly divided into A group（n=44）and B group（n=43）. The patients in A group were treated with 80 mg valsartan everyday,and the patients in B group were treated with 5-10mg benazepril everyday. The patients of two groups were both treated for four weeks. Before and after treatment, 24h ambulatory blood pressure monitoring（ABPM）, fasting blood glucose（FBG）and fasting insulin（FINS）were detected respectively,and homeostasis model assessment-insulin re- sistance（HOMA-IR）and homeostasis model assessment-insulin sensitive（ HOMA-IS） were obtained. Results： After four weeks of the treatments, blood pressures, HOMA-IR and HOMA-IS all declined obviously in both groups（P〈0. 05）, but there were no significant difference between A group and B group（P〉0.05）. Conclusion： Valsartan and benazepril might decrease blood pressure of patients with mild to moderate essential hypertension, both could improve insulin reslstance.