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目的 :了解氯沙坦对老年原发性高血压患者胰岛素抵抗 (IR)的影响。方法 :采用连续样本 ,自身前后对照的研究方法 ,以 18例健康老年人为对照 ,观察 36例单纯高血压患者 (EH组 )服用氯沙坦 5 0mg前及 12周后的平均动脉压 (MAP)、空腹及餐后 2h血糖 (BG)、血胰岛素 (IS)、C肽 (CP)值 ,计算出胰岛素敏感指数 (ISI)。结果 :EH组空腹及餐后 2hIS及CP值均显著高于对照组 ,ISI明显低于对照组 (P <0 0 1) ,经氯沙坦治疗后 ,EH组除MAP显著下降 (P <0 0 1)外 ,空腹及餐后 2hIS值亦明显降低 (P <0 0 5 ) ,ISI显著升高 (P <0 0 5 )。结论 :老年高血压者存在IR ,氯沙坦不仅有良好的降压效果 ,并能改善高血压患者的IR
Objective: To investigate the effect of losartan on insulin resistance (IR) in elderly patients with essential hypertension. Methods: The continuous arterial pressure (MAP) was measured before and after losartan 50 mg in 36 hypertensive patients (EH group) with 18 healthy elders as controls. (BG), blood insulin (IS) and C peptide (CP) were measured in fasting and postprandial 2hours to calculate insulin sensitivity index (ISI). Results: The fasting and postprandial 2 h IS and CP values in EH group were significantly higher than those in control group, and the ISI was significantly lower than that in control group (P <0.01). After losartan treatment, the MAP in EH group decreased significantly (P <0 0 1), fasting and postprandial 2hIS values were also significantly lower (P <0 05), ISI was significantly higher (P <0 05). Conclusion: IR in elderly hypertensive patients, losartan not only has a good antihypertensive effect, and can improve the IR of patients with IR