吡格列酮对EH合并IGT患者血管内皮依赖性舒张功能的影响

The effect of Pioglitazone on flow mediated endothelium-dependent dilatation function in patients with essential hypertension and impaired glucose tolerance

目的 对原发性高血压（EH）合并糖耐量减低（IGT）患者,比较吡格列酮治疗组和对照组治疗前后的血管内皮依赖性舒张功能（FMD）的变化,探讨吡格列酮对血管内皮功能的影响.方法 筛选68例EH合并IGT患者,随机分为吡格列酮治疗组35例和对照组33例.治疗组给予盐酸吡格列酮30 mg,每日早上一次顿服,同时进行降压治疗、饮食和运动控制,一共持续12周,对照组仅进行降压和饮食运动控制.在治疗前后测量受试者血压、空腹血糖（FPG）、空腹血胰岛素（FINS）、餐后2h血糖（2 hPG）、糖化血红蛋白（HbA1c）、血脂采用稳态模型法计算胰岛素抵抗指数（IRI）,IRI=（空腹血糖×空腹胰岛素）/22.5,同时进行肱动脉超声检查评价FMD.结果 治疗组FMD治疗后比治疗前明显改善[（10.38±2.45） vs（8.96±2.29）],P＜0.05,而对照组FMD治疗前后差异无统计学意义[（8.83±2.38） vs（9.08±2.49）],P＞ 0.05.结论 吡格列酮可以改善胰岛素抵抗,降低餐后血糖,从而改善EH合并IGT患者的血管内皮依赖性舒张功能.

Objective To study the effect of Pioglitazone on flow mediated endothelium-dependent dilatation function （FMD） in patients with essential hypertension （EH） and impaired glucose tolerance （IGT） by comparing FMD before and after the therapy of Pioglitazone.Methods 68 patients with EH＆amp;IGT were selected and randomly divided into Pioglitazone group （35 cases） and control group （33 cases）.Pioglitazone group received Pioglitazone 30 mg once every morning,anti-hypertension therapy,physical exercise and diet control for 12 weeks; while control group received anti-hypertension therapy,physical exercise and diet control only.Measured patients＇ blood pressure,fasting plasma glucose （FPG）,fasting insulin （FINS）,2 hours postprandial plasma glucose （2hPG）,glycated hemoglobin （HbA1c）,blood fat,insulin resistance index [IRI,IRI =（FPG × FINS）/22.5],FMD.Results FMD improved significantly after treatment in Pioglitazone group [（10.38 ± 2.45） vs.（8.96 ± 2.29）,P 〈 0.05],there was no statistically significant difference before and after treatment in control group [（8.83 ± 2.38） vs.（9.08 ± 2.49）,P 〉 0.05].Conclusion Pioglitazone reduced insulin resistance and 2hPG,enhanced FMD.