依那普利对高血压病患者降压作用及其对血胰岛素水平的影响

Effect of enalapril on blood pressure and blood insulin level in patients with essential hypertension

目的探讨依那普利对高血压病患者的降压作用及其对胰岛素抵抗的影响。方法对38例高血压病患者和18例健康对照者行口服葡萄糖耐量试验，测定其血糖和血胰岛素水平，计算其释放曲线下面积，并于38例高血压病患者接受依那普利降压治疗4WK后，进行相同检测。结果治疗前，两组空腹血糖无明显差别；依那普利治疗后，患者血压明显下降，且高血压病组空腹血胰岛素和服糖后血糖、血胰岛素及其释放曲线下面积，均显著高于对照组。依那曾利治疗4WK后，糖耐量试验显示，糖负荷后1h、2h的血糖和释放曲线下面积、空腹与糖负荷后各点的血胰岛素和释放曲线下面积均较治疗前显著降低。结论高血压病患者存在糖耐量降低、高胰素血症和胰岛素抵抗。依那普利能够降低高血压病患者血胰岛素水平，具有改善其胰岛素抵抗的作用。

Objective To research the effect of enalapril on the insulin resistance in patients with essential hypertension. Methods Blood glucose, insulin and releasing areas under the curve were measured and calculated during a glucose tolerance test in 38 hypetensive patients and 18 control healthy subjects. After the enalapril was used to treat hypertension (38 cases) for four weeks, the same measures were done. Results Before treatment of enalapril, there were not significant difference in blood glucose between essential hypertension and the control subjects, but the hypertentive patients had higher fasting serum, higher plasma glucose and serum insulin at postload, higher releasing areas under the curve then those of the control subjects, After treattment the plasma glucose level at 1, 2hour postload and releasing areas under the curve, the serum insulin levels at fasting and 1,2, 3hour postload and releasing areas under the curve were all lowered significantly compared to pretreatment. Conclusion There were hyperinsulinemia, glucose intolerance and insulin resistance is improved by the treatment of enalapril in - patients with essential hypertension.