替米沙坦对高血压合并2型糖尿病患者胰岛素抵抗的影响

The effect of telmisartan on the insulin resistance of hypertensive patients complicated with type 2 diabetes mellitus

目的分析替米沙坦应用于高血压合并2型糖尿病患者的疗效及对胰岛素抵抗指数（HOMA—IR）的影响。方法选取2011年5月～2012年7月期间我院相关科室所收治的120例高血压合并2型糖尿病患者为研究对象，并将其随机分作两组．对照组60例以氨氯地平片进行治疗，实验组60例则以替米沙坦片治疗。对两组患者的降压效果与HOMA—IR的变化情况进行分析。结果对照组与实验组患者的血压均得到了良好的控制，降压效果明显，组内差异较大，P〈0．05；组间差异不大，P〉0．05。对照组中，治疗6、12周后患者的HOMA—IR分别为5．08±0．85、4．96±0．78；实验组中，治疗6、12周后患者的HOMA—IR分别为4．73±0．68、4．23±0．78，比较两组差异较大，具有统计学意义，P〈0．05。治疗6、12周后两组患者的HOMA—isle（胰岛B细胞功能）差异较大，P〈0．05。结论替米沙坦的降压效果较好而且稳定，对患者的胰岛素抵抗及胰岛B细胞功能改善的作用更为显著。

Objective To analyze the effect of telmisartan on the hypertensive patients complicated with type 2 diabetes mellitus and HOMA-IR （insulin resistance）. Methods 120 patients suffered hypertension complicated with type 2 diabetes mellitus were selected from May 2011 to Jul 2012. They were randomly divided into two groups. In the control group, 60 patients were treated with amlodipine, and in the research group, 60 patients were treated with telmisartan. Analyzed the antihyperten- sive effect and HOMA-IR changes between the two groups. Results All patients＂ blood pressure were controlled.There were significant difference within the group （P〈0.05）, but there were no difference between the two groups （P〉0.05）. In the control group, treatment continued for 6 weeks and 12 weeks, HOMA-IR of patients were （5.08±0.85）, （4.96±0.78） respectively. In the research group, treatment continued for 6 weeks and 12 weeks, HOMA-IR of patients were （4.73±0.68）, （4.23±0.78） respec- tively. There were significant differences between two groups （P〈0.05）. In two groups, treatments continually offered for 6 weeks and 12 weeks, HOMA-isles（Isle β-cell function） of the two groups were significantly different （P〈0.05）. Conclusion The antihypertensive effect of telmisartan is better and stable. Telmisartan significantly improve insulin resistance and pancreatic β- cell function of patients.