ACEI制剂对高血压患者胰岛素敏感性的影响

The Effect of ACEI on Insulin Sensitivity of Patients with Essential Hypertension

目的 探讨ACEI制剂蒙诺对高血压患者胰岛素敏感性的影响。方法 12 4例高血压合并胰岛素抵抗患者随机分为两组。治疗组 62例 :男 3 2例 ,女 3 0例 ,年龄 ( 5 2± 6.5 )岁 ,使用ACEI制剂蒙诺 ,每日 1次 ,每次 10mg口服 ;对照组 62例 ,男 3 3例 ,女 2 9例 ,年龄 ( 5 3± 7.2 )岁 ,使用钙拮抗剂硝苯地平 ,每日 3次 ,每次 10mg口服。使用葡萄糖胰岛素钳夹技术测定葡萄糖代谢率 ,作为胰岛素敏感性指标 ,并观察血压变化 ,疗程 8周。结果 ( 1)两组患者治疗后血压均较治疗前有显著降低 (P <0 .0 1) ,两组之间差异无显著性 (P >0 .0 5 ) ;( 2 )胰岛素敏感性指标 ,治疗组治疗前后差异有显著性 ( 4 .4± 0 .4 )mg·kg-1·min-1与 ( 6.9± 0 .9)mg·kg-1·min-1(P <0 .0 1) ;对照组治疗前后差异无显著性 ( 4 .2± 1.2 )mg·kg-1·min-1与 ( 4 .6± 1.0 )mg·kg-1·min-1(P >0 .0 5 ) ,两组之间差异有显著性 (P <0 .0 1) ;( 3 )两组患者治疗前后Tch和HDL均无显著变化 ,治疗 8周后治疗组TG有显著降低(P <0 .0 5 ) ,两组比较差异有显著性 (P <0 .0 5 )。

Objective To investigate the effect of ACEI on insulin sensitivity (IS) of patients with essential hypertension (EH).Methods 124 EH patients were measured their glucose metabolism rate (M) as an index of IS by euglycemic insulin clamp . They were randomly divided into 2 groups: Treatment group including 62 patients (M32,F30)with an average age of 52±6.50 was treated with Monopril, 10 mg, qd,PO; and the control group including 62 patients (M33,F29) with an average age of 53±7.2 was treated with Nimodipine, 10mg,tid PO. Both treatment period lasted 8 weeks.Results Monopril and Nimodipine both significantly reduced blood pressure as compared with that before treatment ( P <0.01). There was no great difference between two groups ( P >0.05). M value (mg·kg 1· min -1 ) of patients in treatment group after the use of Monopril was higher than that before treatment (4.5±0.4 vs. 6.9±0.9, P <0.01). There was significant difference between two groups ( P <0.05). In treatment group, patients' TG after the use of Monopril significantly reduced as compared with that before treatment (2.8±0.7 vs. 1.7±0.4, P <0.05). There was significant difference between two groups ( P <0.05).Conclusion ACEI can improve insulin sensitivity in patients with essential hypertension.