厄贝沙坦联合氨氯地平对2型糖尿病并高血压患者胰岛素抵抗及胰岛β细胞功能的影响

Impact of Irbesartan Combined with Amlodipine on Insulin Resistance and Pancreatic Islet β-cell Function of Type 2 Diabetes Mellitus Patients Complicated with Hypertension

目的探讨厄贝沙坦联合氨氯地平对2型糖尿病并高血压患者胰岛素抵抗及胰岛β细胞功能的影响。方法选取2015年9月—2016年5月咸阳市第一人民医院收治的2型糖尿病并高血压患者100例,采用随机数字表法分为对照组和观察组,每组50例。在常规治疗基础上,对照组患者给予氨氯地平治疗,观察组在对照组基础上加用厄贝沙坦治疗;两组患者均连续治疗两个月。比较两组患者临床疗效,治疗前后空腹血糖、糖化血红蛋白(Hb A1c)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、收缩压、舒张压及24 h尿蛋白定量。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者空腹血糖、Hb A1c、HOMA-β、HOMA-IR比较,差异无统计学意义(P>0.05);治疗后观察组患者空腹血糖、Hb A1c、HOMA-IR低于对照组,HOMA-β高于对照组(P<0.05)。治疗前两组患者收缩压、舒张压及24 h尿蛋白定量比较,差异无统计学意义(P>0.05);治疗后观察组患者收缩压、舒张压及24 h尿蛋白定量低于对照组(P<0.05)。结论厄贝沙坦联合氨氯地平可有效降低2型糖尿病并高血压患者血压,改善其胰岛素抵抗及胰岛β细胞功能。

Objective To investigate the impact of irbesartan combined with amlodipine on insulin resistance and pancreatic islet β- cell function of type 2 diabetes mellitus patients complicated with hypertension. Methods A total of 100 type2 diabetes mellitus patients complicated with hypertension were selected in the First People’s Hospital of Xianyang from September2015 to May 2016,and they were divided into control group and observation group according to random number table,each of 50 cases. Based on conventional treatment, patients of control group received amlodipine, while patients of observation group received irbesartan combined with amlodipine; both groups continuously treated for 2 months. Clinical effect, FBG, Hb A1 c,HOMA-β,HOMA-IR,SBP,DBP and 24- hour urinary protein quantity before and after treatment were compared between the two groups. Results Clinical effect observation group was statistically significantly better than that of control group（ P 〈 0. 05）.No statistically significantly differences of FBG, Hb A1 c,HOMA-β or HOMA-IR was found between the two groups before treatment（ P 〉 0. 05）,after treatment,FBG,Hb A1 cand HOMA-IR of observation group were statistically significantly lower than those of control group,while HOMA-β of observation group was statistically significartly higher than that of control group（ P〈 0. 05）. No statistically significant differences of SBP,DBP or 24- hour urinary protein quantity was found between the twogroups before treatment（ P 〉 0. 05）, while SBP, DBP and 24- hour urinary protein quantity of observation group were statistically significantly lower than those of control group after treatment（ P 〈 0. 05）. Conclusion Irbesartan combined with amlodipine can effectively reduce the blood pressure, relive the insulin resistance and improve the pancreatic islet β- cell function of type 2 diabetes mellitus patients complicated with hypertension.