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目的 :探讨络活喜、心痛定、卡托普利对原发性高血压 ( EH)患者胰岛素敏感性的干预作用。方法 :将 97例 EH患者随机分为 3组分别用络活喜、心痛定、卡托普利治疗 ,在治疗前、治疗后 2周、4周、6周分别测定空腹血糖、血胰岛素、糖负荷试验 60 min、1 2 0 min血糖、血胰岛素并进行比较。结果 :心痛定组治疗前后空腹血糖、血胰岛素及糖负荷试验后血糖、血胰岛素水平差异无显著性 ;络活喜组治疗 4周、6周后糖负荷试验后 60 min、 1 2 0 min血糖水平下降 ( P<0 .0 5 ,P<0 .0 1 ) ,空腹胰岛素、糖负荷试验后 60 min、1 2 0 min胰岛素水平下降 ( P<0 .0 1 ) ;卡托普利组治疗 4周、6周后 ,空腹胰岛素、糖负荷试验 60 min、1 2 0 min胰岛素水平下降明显 ( P<0 .0 5～ 0 .0 0 1 ) ,4周、6周后糖负荷试验 60 min、1 2 0 min血糖水平低于治疗前 ( P<0 .0 1 )。结论 :卡托普利、络活喜在降压的同时 ,降低 EH患者的高胰岛素血症 ,提高胰岛素的敏感性 ;而心痛定则对 EH患者的代谢紊乱无明显正、反面影响
Objective: To investigate the effects of lohexin, xintongding and captopril on insulin sensitivity in patients with essential hypertension (EH). Methods: Ninety-seven patients with EH were randomly divided into three groups, treated with loratoside, xintongding and captopril respectively. The levels of fasting blood glucose, blood insulin, glucose Load test 60 min, 120 min blood glucose, blood insulin and compared. Results: The levels of fasting blood glucose, blood insulin and glucose and insulin before and after treatment in Xintongding group had no significant difference. After 4 weeks and 10 weeks after sugar loading test, (P <0.05, P <0.01), fasting insulin and insulin decreased 120 min (P <0.01) at 60 min after glucose stress test After 4 weeks and 6 weeks, fasting insulin and glucose load test decreased significantly at 60 min and 120 min (P <0.05-0.0.01) , Blood glucose level was lower than that before treatment (P <0.01) at 120 minutes. Conclusions: Captopril and lovastatin can reduce hyperinsulinemia and increase insulin sensitivity in patients with EH at the same time of lowering blood pressure. However, there is no significant positive and negative effects of nifedipine on metabolic disorders in patients with EH