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目的:探讨血管紧张素Ⅱ受体阻滞剂(ARB)缬沙坦降压的同时对胰岛素抵抗(IR)的影响。方法:入选原发性高血压并空腹血糖调节受损患者124例,依就诊顺序随机分为2组,其中缬沙坦组64例,硝苯地平组60例。观察比较治疗前后血压空腹血糖空腹胰岛素(F ins),计算胰岛素作用指数(IA I)。结果:2组治疗后血压均较治疗前明显下降(P<0.05),治疗前后及组间血糖比较差异无统计学意义(P>0.05);治疗后缬沙坦组F ins水平下降,IA I较治疗前明显改善(P<0.05),与硝苯地平组比较,差异均有统计学意义(P<0.05)。硝苯地平组F ins、IA I治疗前后无明显变化(P>0.05)。结论:高血压合并空腹血糖调节受损患者胰岛素敏感性均降低,使用缬沙坦治疗后,胰岛素敏感性均显著提高。
Objective: To investigate the effect of valsartan on insulin resistance (IR) while angiotensin Ⅱ receptor blocker (ARB). Methods: A total of 124 patients with essential hypertension and impaired fasting glucose regulation were randomly divided into two groups according to the order of their visits: 64 in the valsartan group and 60 in the nifedipine group. The fasting blood glucose fasting insulin (F ins) was observed and compared before and after treatment, and the insulin action index (IA I) was calculated. Results: After treatment, the blood pressure of two groups were significantly decreased (P <0.05), but there was no significant difference in blood glucose before and after treatment (P> 0.05). After treatment, F ins level in Valsartan group was decreased, IA I (P <0.05). Compared with the nifedipine group, the differences were statistically significant (P <0.05). Nifedipine group F ins, IA I no significant change before and after treatment (P> 0.05). CONCLUSION: The insulin sensitivity of hypertensive patients with impaired fasting glucose regulation decreased. After valsartan treatment, the insulin sensitivity was significantly increased.