缬沙坦对高血压病患者高胰岛素血症的影响

Effect of valsartan on hyperinsulincmia of different risk groups in essential hypertension patients

目的:评价血管紧张素Ⅱ受体拮抗剂缬沙坦对高血压病患者高胰岛素血症的影响。方法:分别测定高血压病低、中、高危险组患者口服缬沙坦8周前、后及正常人的空腹血糖(FPG)、空腹血浆胰岛素水平(FPI)和胰岛素敏感指数(IAI),以评价缬沙坦的作用。结果:高血压病低、中、高危险组患者FPI高于正常对照组,IAI低于正常对照组,P均<0.05,提示高血压病患者存在高胰岛素血症和胰岛素抵抗。缬沙坦治疗可以降低低、中危险组高血压病患者的FPI,增加其IAI(P均<0.05),但对高危险组FPI和IAI无明显影响。缬沙坦在低、中危险组对FPI、IAI的影响无明显差别。结论:缬沙坦可以减轻高血压病低、中危险组患者的高胰岛素血症,改善胰岛素抵抗,而对其高危险组患者无此作用。

Objective: To observe the effect of valsartan on hyperinsulinemia of different risk groups in essential hypertension (EH) patients. Methods:FPG, FPI and IAI were measured in normal people and in EH patients before and after valsartan therapy, which were used to appraise effect of valsartan on hyperinsulinemia. Results: There was no difference in FPG between normal peoples and EH patients. FPI was higher and IAI was lower in EH patients than normal controls (P<0. 05 all). Valsartan decreased FPI level, increased IAI in low-risk and moderate-risk EH patients (P<0. 05 all), but had no effect in high-risk patients. There were similar effects of valsartan on hyperinsulinemia and insulin resistance in low-risk and moderate-risk patients. Conclusion: Valsartan can ameliorate hyperinsulinemia and insulin resistance in EH patients with low-risk and moderate-risk, but has no effect in high-risk patients.