血管紧张素受体拮抗剂对2型糖尿胰岛β细胞功能的影响

Effect of Angiotensin Ⅱ Type 1 Receptor Antagonist on β-cell Function in Type 2 Diabetes

【目的】观察厄贝沙坦对2型糖尿病（T2DM）患者胰岛β细胞功能影响。[方法]62名T2DM患者分为观察组34例及对照组28例，对照组予以饮食控制及胰岛素治疗，治疗组在对照组的基础上加服厄贝沙坦0．15g口服，一天一次。治疗前、治疗三个月后分别进行口服葡萄糖耐量试验（OGTT）和C肽释放试验，比较两组治疗前和治疗后血糖（PG）、稳态模型评估法胰岛素抵抗指数（HOMA-IR）、胰岛细胞功能指数（HOMA-β）、胰岛素分泌指数[糖负荷30min净增C肽与净增葡萄糖的比值（△C30／△G30）及以糖负荷120min净增C肽与净葡萄糖的比值（△C120／△G120）]。【结果】①两纽空腹血糖（FPG）、糖负荷后2小时血糖（2hPG）、糖化血红蛋白（HbAlc）治疗三个月前后差异有统计学意义（均为P〈0．05）；治疗前及治疗后两组之间差异均无统计学意义（P〉0．05）。②胰岛功能指标：两组HOMA-IR，HOMA-β、△C30／△G30、△C120／△G120治疗三个月前后差异均有统计学意义（均为P〈0．05）；治疗前两组各指标之间差异无统计学意义（P〉0．05）。三个月后观察组较对照组各指标改善显著，两组之间差异有统计学意义（P〈0．05）。【结论】厄贝沙坦治疗T2DM，能显著改善胰岛β细胞功能。

[Objective] To observe the influence of angiotensin Ⅱ type 1 receptor antagonist （irbesartan） on β-cell function in type 2 diabetes（T2DM）. [Methods] A total of 62 inpatients with T2DM were randomly assigned to irbesartan group with 3-month irbesartan treatment and control group without irbesartan treat ment. Before and after 3 months, irbesartan group and control group performed oral glucose tolerance test （OGTT） and C-peptide release test. The changes of plasma glucose, HbAcl, HOMA IR, HOMA-B, △C30/ △G30 and △C120/△G120 in two groups were compared. [Results]In two groups, plasma glucose, HbAcl and HOMA-IR were decreased（ P 〈0.05）, HOMA-B, △C30/AG30 and AC120/AG120 were increased significant ly after 3 months （ P d0.05）, and HOMA-B,△C30/△G30 and △C120/△G120 were changed after 3 months but increased markedly after irbesartan therapy （ P 〈0.05）. [Conclusion] In T2DM patients, irbesartan can improve β-cell function（insulin sensitivity and insulin secretion）.