咪达普利对高血压合并糖耐量减低患者血管内皮依赖性舒张功能的影响

Influence of imidapril on endothelium-dependent diastolic function in hypertension patients with impaired glucose tolerance

目的探讨咪达普利对高血压合并糖耐量减低(impaired glucose tolerance,IGT)患者血管内皮依赖性舒张功能的影响。方法咪达普利5～10 mg/d治疗高血压合并IGT患者50例,疗程3个月,分析治疗前后血压、空腹血糖(fasting plasma glucose,FPG)、糖负荷后2 h血糖(2-hour plasma glucose,2hPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(HOMA-insulin resistance index,HOMA-IR)、血浆一氧化氮(NO)的变化,利用高频超声血管技术检测咪达普利治疗前后肱动脉内皮依赖性舒张(endothelium-dependent diastolic,EDD)功能,计算其舒张内径的变化率(flow mediated dila-tion,FMD)。结果与治疗前比较,治疗后患者的收缩压显著下降(P<0.01),舒张压、FINS、HOMA-IR均下降(P<0.05),血浆NO水平、FMD升高(P<0.05)。治疗前后FMD变化值(ΔD)分别与FINS、HOMA-IR、NO及其相应变化值ΔFINS、ΔHOMA-IR、ΔNO相关。结论咪达普利对高血压合并IGT患者在有效降压的同时,能明显改善内皮依赖性舒张功能。

Objective To explore the effects of imidapril on endothelium-dependent diastolic（EDD） function in hypertension patients with impaired glucose tolerance（IGT）.Methods Fifty hypertension patients with IGT were treated with imidapril 5-10 mg/d for three months.Before and after treatment,blood pressure,fasting plasma glucose（FPG）,2 h plasma glucose（2hPG）,fasting insulin（FINS）,insulin-resistance index（HOMA-IR）,nitrogen monoxidum（NO） were determined.High-frequency ultrasonic imaging was used to detect the changes of brachial artery EDD function after administration with imidapril,then calculate diastolic inner diameter changing rate（FMD）.Results Compared with pretherapy,the systolic blood pressure was reduced（P0.01）.The diastolic blood pressure,FINS and HOMA-IR were decreased（P0.05）.The plasma NO and FMD were increased（P0.05）.Before treatment,FMD was correlated with FINS,HOMA-IR and plasma NO,the change of FMD before and after treatment was correlated with the change of FINS,HOMA-IR and plasma NO.Conclusion Imidapril can reduce the blood pressure,improve EDD function in hypertension patients with IGT.