氨氯地平与二甲双胍合用对HP患者IR的改善

Amlodipine combined with metformin improve IR in the HP patients

目的观察氨氯地平和二甲双胍联合用药对高血压病(hypertensive disease,HP)患者胰岛素抵抗(insulinre-sistance,IR)的改善观察,并探讨联合用药的效果。方法 78例高血压患者随机分为治疗组和对照组,两组入选对象均确保停用降压药≥5个半衰期,且性别、年龄、体重指数、血压及入选时空腹及餐后血糖等指标差异均无统计学意义,具有可比性。对照组加用氨氯地平,治疗组在氨氯地平治疗基础上加用二甲双胍。结果用药后,两组患者的收缩压(SBP)和舒张压(DBP)均有明显下降(P<0.05);胰岛素敏感指标ISI均有升高(P<0.05),但治疗组ISI升高幅度大于对照组(P<0.05),二组的血压比治疗前均显著降低(P<0.01),且以联合用药组疗效更为显著(P<0.05),不良反应更少。结论氨氯地平片可提高患者的胰岛素敏感性,从而改善了IR。而联合使用二甲双胍,则可使高血压患者降压药的用量减少,胰岛素敏感性较单独用药(对照组)提高得更为显著。

Objective To observe the improvement of the high blood pressure patients after took the medicine combine with Amlodipine and Metformin and discuss the effect of this combination. Methods Divide 78 patients with high blood pressure into treatment and control group. Both group stopped using depressor for no less than 5 half-lives. There are no obvious difference between two groups in terms of gender, age, weight index, blood pressure, empty stomach at the start and blood sugar after meal and they are comparable. The control group were on Amlodipine while the treatment group were added with Mefformin. Results There are obviously drop （P 〈 0. 05） of both SBP and DBP in both groups after the medication, and a rise of ISI （ P 〈 0.05 ）. However, the treatment group has a higher increased rate of ISI than the control group, the blood pressure dropped sharply com- pared with it before the patients took medicine in both groups, and the treatment group showed more significant effect with less side effects. Conclusion Amlodipine can raise the sensitivity of insulin of patients and hence to improve the IR. To combine it with Mefformin can allow the patients to use less amount of depressor, also the improvement of sensitivity of insulin is higher compared with the contrast group.