氯沙坦对原发性高血压病人胰岛素抵抗性的影响

Effect of losartan on insulin resistance in patients with essential hypertension

目的 探索氯沙坦对高血压病的疗效及对胰岛素抵抗的影响。 方法 采用随机单盲对照法治疗原发性高血压 32例 ,用氯沙坦 5 0mg·d-1,疗程 6周。对照组为 31例 ,用福辛普利 10mg·d-1,疗程 6周。 结果 氯沙坦组治疗后收缩压下降 (18± 6 )mmHg(P <0 0 1) ,舒张压下降 (12± 7)mmHg(P <0 0 1) ,福辛普利组治疗后收缩压下降 (15± 8)mmHg(P <0 0 1) ,舒张压下降 (14± 6 8)mmHg(P <0 0 1) ,氯沙坦组治疗后糖负荷后 12 0min胰岛素下降 (13± 11)mU·L-1(P <0 0 5 ) ,胰岛素敏感指数下降 (3 1± 2 ) (P <0 0 5 ) ,福辛普利组治疗后 12 0min时胰岛素下降(17± 15 )mU·L-1(P <0 0 1) ,胰岛素敏感指数下降 (3 8± 3) (P <0 0 1) ,氯沙坦组治疗后血清尿酸水平降低 (0 0 4±0 0 1)mmol·L-1(P <0 0 5 ) ,福辛普利组治疗后血清尿酸水平无明显变化。 结论 氯沙坦治疗高血压病人有改善胰岛素抵抗和降低血尿酸水平的作用。

Objective To explore the effect of losartan on insulin resistance in patients with essential hypertension. Methods In a randomized,single-blind and controlled design,losartan was used in a dosage of 50mg once daily in 32 patients with essential hypertension for 6 week and was compared with that of fosinopril(10mg·d -1 ,for 6 week)in 31 patients. Results Both losartan and fosinopril significantly reduced SBP[by a mean of (18±6)and (15±8)mmHg respectively]and DBP[by a mean of (12±7)and (14±6 8)mmHg respectively].Both losartan and fosinopril decreased plasma insulin 2 hours after 75g glucose intake[(13±11),(17±15)mU·L -1 ] and insulin sensitivity index(3 1±2),(3 8±3).Losartan reduced serum uric acid(0 04±0 01)mmol·L -1 ,however,fosinopril did not exhibit this situation. Conclusions Losartan improves insulin resistance and reduces serum uric acid in essential hypertension.