依那普利对高血压患者胰岛素抵抗影响的临床观察

Effects of enalapril on insulin resistance in patients with essential hypertension

目的 :观察依那普利对高血压病 (EH)患者胰岛素抵抗 (IR)的影响。方法 :49例EH患者依那普利治疗前及 5～ 15mg/d治疗 8周后 ,分别检测空腹血糖 (FPG)及空腹血胰岛素 (FPI) ,计算胰岛素敏感指数 (IAI) ,并以 2 8例性别、年龄、体重指数相当的健康者作对照组。结果 :2组FPG差异无显著性 ,均正常。EH组FPI显著升高 (P <0 .0 1)、IAI显著降低 (P <0 .0 1)。依那普利治疗 8周后 ,FPI明显下降 (P <0 .0 1) ,IAI明显升高 (P <0 .0 1)。结论 :依那普利在稳定降压的同时IR也得到了明显改善。

Aim:To determine the effects of enalapril on insulin resistance in patients with hypertension.Methods:49 patients with essential hypertention(EH)were treated with enalapril 5～15 mg/d for 8 weeks .The blood pressure, fasting serum glucose and insulin levels were measured, and insulin sensitivity index was calculated before and after treatment . The results in patients with EH were compared with those in 28 healthy controls matched with the EH group in age, sex and body mass index.Results: There was no obvious difference for blood glucose between two groups . The level of fasting serum insulin in patients with EH was higher and the insulin sensitivity index was lower than those of controls( P <0.01 respectively). In patients with hypertension, the p SB and p DB significantly decreased( P <0.01 and P <0.05), the level of fasting serum insulin decreased obviously ( P <0.01), but the insulin sensitivity index increased ( P <0.01) after 8 weeks of treatment of enalapril. Conclusion: The study indicates enalapril has beneficial effects on lowering blood preasure and improving insulin resistance in patients with EH.