罗格列酮对老年2型糖尿病合并高血压患者血压的影响

Effects of Rosiglitazone on the Blood Pressure in Elderly Patients with Type2 Diabetes And Hypertension

目的:观察胰岛素增敏剂罗格列酮用于老年2型糖尿病合并高血压的患者时,降低血浆胰岛素水平以及改善胰岛素敏感性后对血压的影响。方法:23例老年2型糖尿病合并高血压患者口服罗格列酮(文迪雅)4mg～8mg,1次/日。治疗前后测定BMI、血压、HbA_(1C)、FBG、PBG、FINS、PINS,并按HOMA模型计算胰岛素抵抗指数、胰岛素分泌指数和药物的不良反应。结果:(1)罗格列酮治疗12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(6.75±0.03)/(7.25±0.53)mmHg,与治疗前比较有显著性差异。(2)治疗后HbA_(1C)、FBG、PBG、FINS、PINS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,与治疗前比较有显著性差异,FINS/FBG无显著性差异。(4)我国老年患者使用罗格列酮的安全性及耐受性较好。结论:罗格列酮治疗中国老年2型糖尿病患者,能降低血浆胰岛素水平,改善IR,显著降低收缩压和舒张压;且其安全性、耐受性均较好。

Objective: To investigate the effects of insulin increasing-sensitivity agent (Rosiglitazone) on the blood pressure in type 2 diabetic and hypertensive patients. Methods: Twenty-three type 2 diabetic and hypertensive patients received orally rosiglitazone (4 mg～8 mg·qd) for 12 weeks. BMI、BP、HbA1C、FBG(Fasting blood glucose)、PBG(2 hour glucose after meal)、FINS (Fasting insulin) and PINS (2 hour insulin after meal) were measured before and after the trial. Insulin resistance index and insulin secretion index were calculated by Homestasis Model Assessment (HOMA). Results: (1) BP was decreased significantly after treatment, range of decreasing BP being 6.75± 0.03/ 7.25± 0.53 mmHg. There was not significant difference about BMI before and after the treatment.(2)There was significant decrease in HbA1C、FBG、PBG、FINS、PINS after the treatment.(3)After the trial, HOMA-IR(insulin resistance)decreased and ISI (insulin sensitivety index) increased significantly, but there was not siginficant in FINS/FBG.(4)Rosiglitazone is effective and safe in the treatment of elderly patients with Type 2 Diabetes and hypertension. Conclusion: Rosiglitazone can lower the level of blood glucose,HbA1C and insulin. It can improve insulin sensitivity and decrease BP as well.