二甲双胍对老年高血压患者胰岛素抵抗和内皮功能的影响

The effects of metformin on endothelium function and insulin resistance in patients with hypertension

目的 研究二甲双胍对老年高血压病患者胰岛素抵抗和内皮功能的影响。方法83例老年高血压患者随机分为对照组和二甲双胍组，均给予降压治疗，二甲双胍组还给予二甲双胍0．25g，每日2次。研究对象在初始均常规测定血压、血液生化、空腹血糖、空腹胰岛素及肱动脉血流介导的血管舒张功能（flow-mediated dilation，FMD），在治疗的第8天和第90天重复测定上述指标。结果治疗3个月后二甲双胍组稳态胰岛素评价指数（HOMA—IR）由4．25±1．75下降至2．01±0．85，FMD由5．30±2．09上升至8．68±2．35（P〈0．05）。两组降压程度一致。结论二甲双胍能降低老年高血压患者的胰岛素抵抗并改善内皮功能。

Objective To investigate the effects of metformin on endothelium function and insulin resistance in patients with hypertension. Methods Eighty - three patients with hypertension were randomly divided into control group and metformin group （ metformin 0.25 g, bid ）. Each group were treated with the antihypertensive therapy. Blood pressure, blood biochemistry, fasting blood glucose, fasting blood insulin and FMD were measured before and after 8 days and 90 days of treatment. Results HOMA - IR of mefformin group were improved after three months treatment from （ 4. 25±1. 75 ） to （2.01 ± 0.85 ） , FMD of metformin group were improved after three months treatment from （5.30 ±2. 09） to （8.68± 2.35 ）. There was no significant difference to the effect of the decrease of hypertension between the two groups. Conclusions Metforrnin could directly improve endothelium function and reduce insulin resistance in patients with hypertension.