二甲双胍治疗2型糖尿病人对血压影响的研究

Effects of Metformin on Blood Pressure in Patients with Type 2 Diabetes

目的 观察胰岛素增敏剂二甲双胍治疗 2型糖尿病 ,降低血浆胰岛素水平、改善胰岛素敏感性后对血压的影响。方法 71例 2型糖尿病人口服二甲双胍 (格华止 ) 85 0mg,qd～bid。治疗前后测定BMI、血压、FBG、PBG、FINS、PINS ,并按HOMA模型计算胰岛素抵抗指数和胰岛素分泌指数。结果 (1)二甲双胍治疗 8周后 ,BMI治疗前后比较无显著性差异 ;血压治疗后明显下降 ,降压幅度达 13.1± 4 .9/ 4 .2± 9.9mmHg ,血压治疗前后比较有显著性差异 ;(2 )治疗后FBG、PBG、FINS均明显下降 ,治疗前后比较有显著性差异 ;(3)治疗后HOMA IR下降 ,IAI升高 ,治疗前后比较有显著性差异 ,但HOMA IS、FINS/FBG无显著性差异。结论 二甲双胍治疗 2型糖尿病 ,在降低血浆胰岛素水平、改善IR的同时 ,伴有血压的明显下降。

Objective To investigate the effects of insulin increasing sensitivity agent(Metformin) on blood pressure in type 2 diabetic patients. Methods Seventy one type 2 diabetes received orally metformin (850 mg, qd or bid) for 8 weeks. BMI?BP?FBG(Fasting blood glucose)?PBG(2 hours glucose after meal )?FINS(Fasting insulin) and PINS(2 hours insulin after meal) were measured before and after trial. Insulin resistance index and insulin secretion index were calculated by Homestasis model assessment(MOMA). Results (1)BP was decreased significantly after treatment, range of decreasing BP being 13.1±4.9/4.2±9.9 mmHg; there was not significant difference about BMI before and after treatment. (2) There was significant decrease in FBG?PBG?FINS after treatment. (3) After trial, HOMA IR(insulin resistance) decreased and ISI(insulin sensitivety index) increased significantly, but there was not significant difference in HOMA IS(iusulin secretion) and FINS/FBG. Conclusion Meformin can lower level of blood glucose and insulin, improve insulin sensitivity, and decrease BP as well.