替米沙坦对原发性高血压合并糖调节受损患者胰岛素抵抗的改善作用

Effect of telmisartan on insulin resistance in patients with essential hypertension and impaired glucose regulation

目的探讨替米沙坦和硝苯地平对原发性高血压合并糖调节受损患者胰岛素抵抗的影响。方法原发性高血压伴糖调节受损患者60例,随机分为两组,分别服用替米沙坦(替米沙坦组,n=30)和硝苯地平(硝苯地平组,n=30),观察服药前后糖代谢及胰岛素抵抗等指标。结果患者经6个月的治疗后,替米沙坦组空腹胰岛素、餐后2小时血糖、胰岛素抵抗指数等指标较治疗前明显下降,(9.7±4.3)mU/L vs(8.0±3.9)mU/L(P<0.05),(8.9±1.6)mmol/L vs(7.3±0.8)mmol/L(P<0.05),2.4±1.0 vs 1.6±0.6(P<0.05);治疗后上述指标与硝苯地平组比较,差异均有统计学意义(8.0±3.9)mU/L vs(9.6±3.5)mU/L(P<0.01),(7.3±0.8)mmol/L vs(8.8±0.5)mmol/L(P<0.05),1.6±0.6 vs 2.4±0.9(P<0.05)。硝苯地平组治疗后糖代谢(空腹及餐后2小时血糖)及胰岛素抵抗等指标较治疗前差异无统计学意义(P>0.05)。结论替米沙坦可改善原发性高血压合并糖调节受损患者胰岛素敏感性。

Objective To explore the effect of telmisartan on insulin resistance in patients with essential hypertension and impaired glucose regulation.Methods 30 patients orally received telmisartan and another 30 patients received nifedipine for 6 months.The changes of glucose metabolism and insulin resistance were observed.Results We observed a significant decrease of patients with orally receiving telmisartan in the level of fasting insulin（9.7±4.3） mU/L,（8.0±3.9） mU/L,respectively（P〈0.05）,postprandial 2 h blood sugar（8.9±1.6） mmol/L,（7.3±0.8） mmol/L,respectively（P〈0.05） and HOMA-IR 2.4±1.0,1.6±0.6 respectively（P〈0.05）.There was significant difference in the above parameters between two groups after treatment（8.0±3.9） mU/L vs（9.6±3.5） mU/L（P〈0.01）,（7.3±0.8） mmol/L vs（8.8±0.5） mmol/L（P〈0.05）,1.6±0.6 vs 2.4±0.9（P〈0.05）.There was no change in patients with nifedipine（all P〉0.05）.Conclusion Telmisartan can improve insulin sensitivity in patients with essential hypertension and impaired glucose regulation.