二甲双胍对2型糖尿病血糖及血压的影响

EFFECTS OF METFORMIN ON PLASMA GLUCOSE AND BLOOD PRESSURE IN TYPE 2 DIABETES AND HYPERTENTION

目的观察二甲双胍对2型糖尿病合并高血压病患者血糖及血压的影响。方法 2型糖尿病合并高血压病患者118例随机分为二甲双胍组和格列吡嗪组。二甲双胍1500～2000mg/d,格列吡嗪15～30mg/d,疗程24周,观察2组治疗前后收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、体质量指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、稳态模型胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)、糖化血红蛋白(glycosylated hemoglobin,HbA_1c)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、纤维蛋白原(fibrinogen,FIB)的变化。结果二甲双胍组和格列吡嗪组FPG、HbA_1c治疗后均有明显下降,差异有统计学意义(P<0.05);同时二甲双胍组SBP、DBP、BMI、FINS、HOMA-IR、hs-CRP、FIB有明显降低,差异有统计学意义(P<0.05),而格列吡嗪组SBP、DBP、BMI、hs-CRP,FIB治疗前后无明显变化(P>0.05)。治疗后二甲双胍组SBP、DBP、BMI、hs-CRP、FIB水平明显低于格列吡嗪组(P<0.01)。结论对于2型糖尿病合并高血压病的患者,二甲双胍和格列吡嗪均能显著降低血糖。二甲双胍在降糖的同时,还具有降低血压的作用。

Objective To investigate the effects of metformin on plasma glucose and blood pressure in type 2 diabetes and hypertension. Methods A total of 118 patients with type 2 diabetes and hypertension were randomly divided into two groups of receiving metformin （ 1 500 - 2 000mg/d ） and glipizide （ 15 - 50mg/d） for 24 weeks. Parameters including systolic blood pressure （ SBP）, diastolic blood pressure （ DBP ）, body mass index （ BMI ） , fasting glucose （ FPG ） , fasting insulin （ FINS ）, homeostasis model assessment - insulin resistance （ HOMA - IR ）, glycosylated hemoglobin C （ HbA1c ）, high sensitivity C -reactive protein （hs - CRP）, fibrinogen （FIB）were observed before and after therapy. Results FPG and HbAlc of two groups significantly decreased after treatment; At the same time SBP, DBP,BMI, FINS, HOMA- IR, hs- CRP, FIB in metformin group showed significant decline after treatment （P 〈 0.05 ）. FPG and HbA1 c in glipizide group reduced after treatment （P 〈 0.05 ）. There were no significant changes in sBP＇, DBP, hs - CRP, FIB, FINS, HOMA - IR in glipizide group. After treatment SBP, DBP, BMI, hs - CRP, FIB of metformin group were significantly lower than those of glipizide group （P 〈 0.01 ）. Conclusion For patients with type 2 diabetes and hypertension both metformin and glipizide can decrease plasma glucose. Metformin not only decreases plasma glucose, but also reduces blood pressure.