氯沙坦对高血糖合并高血压患者胰岛素敏感性的影响

Effects of Losartan on Insulin Sensitivity in Hyperglycemic Patients with Hypertension

目的观察氯沙坦对高血糖合并高血压患者胰岛素敏感性的影响。方法将110例高血糖合并高血压患者随机分为两组,分别接受氨氯地平(HG/A组)和氯沙坦(HG/L组)治疗12周。并将两组患者中代谢综合征(MS)患者分别作为MS/A组和MS/L组。治疗前后分别测定患者的体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)和空腹胰岛素(FINS)水平,并计算胰岛素抵抗指数(HOMA-IR)。结果 HG/A组和HG/L组患者在经过12周治疗后,SBP和DBP间差别均有统计学意义(P<0.01),且两组患者SBP和DBP降低幅度间差别有统计学意义(P<0.01)。治疗后HG/L组FINS水平和HOMA-IR与HG/A组比较,差别有统计学意义(P<0.01)。治疗后MS/L组患者FINS水平和HOMA-IR与MS/A组比较,差别有统计学意义(P<0.01)。结论高血糖合并高血压患者在经过氯沙坦治疗12周后,不仅血压下降,而且胰岛素敏感性提高;MS患者经氯沙坦治疗12周后胰岛素敏感性也提高。

Objective To investigate the effects of losartan on insulin sensitivity in hyperglycemic patients with hypertension.Methods One hundred ten hyperglycemic patients with hypertension were divided randomly into 2 groups,who were treated with amlodipine（HG/A group） and losartan（HG/L group）,respectively,for 12 weeks.Patients with metabolic syndromes were treated with amlodipine（MS/A group）,and with losartan（MS/L group）.Body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,glycosylated hemoglobin（HbA1c）,fasting plasma glucose（FPG）,fasting plasma insulin（FINS）,total cholesterol（TC） low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,triglycerides（TG） and homeostasis assessment model of insulin resistance（HOMA-IR）were evaluated before and following treatment.Results After 12 weeks of treatment,SBP and DBP were significantly reduced as compared with baseline in 2 groups（P0.01）.FINS and HOMA-IR decreased more in HG/L group than in HG/A group（P0.01）.FINS and HOMA-IR reduced more in MS/L group than in MS group（P0.01）.Conclusion A 12-week losartan treatment brings about not only a significnat reduction of SBP and DBP but also an improvement of insulin sensitivity in patients with hyperglycosemia with hypertenstion.And insulin sensitivity can also be improved in MS patients.