摘要
目的 研究二甲双胍联合尼群地平和阿替洛尔长期治疗对高血压患者胰岛素抵抗(IR)和代谢的影响。方法 111例轻中度高血压病人,随机分为2组,分别用尼群地平和阿替洛尔联合治疗(A组, n=51)和二甲双胍联合尼群地平和阿替洛尔治疗(B组, n=60),疗程14个月。结果 降压总有效率,A组较B组低,但无显著性差异(P>0.05)。A组病人治疗后较治疗前体重增加(P<0.05),胰岛素敏感指数(ISI)无显著变化(P>0.05),空腹血糖显著升高(P<0.001),低密度脂蛋白显著升高,高密度脂蛋白/低密度脂蛋白比显著下降。B组病人治疗后较治疗前,体重无显著变化,ISI显著升高(P<0.05),血糖、高密度脂蛋白/低密度脂蛋白比和血肌酐显著下降(P<0.05)。二甲双胍联合尼群地平和阿替洛尔治疗能更有效地控制血压,预防体重增加,降低IR,改善血糖代谢和肾功能。结论 二甲双胍和抗高血压药物联合应用可能是一组好的药物配伍。
Objective To investigate the effect of long-term treatment of combinationof metformin with nitrendipine and atenolol on blood pressure, body weight, levelof insulin resistance (IR), glucose tolerance, lipid metabolism and blood creatininein patients with essential hypertension(EH). Methods One hundred eleven patientswith mild to moderate EH were randomly divided into 2 groups: nitrendiping withatenolol group (group A, n=51) and metformin with nitrendipine and atenolol group(group B, n=60). Treatment period lasted for 14 months. Results The totalresponsive rates were 88.2% (45/51) in group A and 96.7% (58/60) in group B(P>0.05). After treatment of combination of nitrendipine with atenolol, bodyweight was significantly increased ( P<0.05). Insulin sensitivity index (ISI) wasunchanged (P>05), fasting blood glucose was significantly increased (P<0.001),low density lipoprotein-cholesterol (LDL-C) was increased markedly (P<0.05), highdensity lipoprotein-cholesterol (HDL-C)/LDL-C ratio was decreased markedly(P<0.05). After treatment of metformin with nitrendipine and atenolol, body weightwas unchanged, ISI significantly increased (P<0.05), both blood glucose, HDL-C/LDL-C ratio and blood creatinine decreased markedly. Compared with treatment ofcombination of nitrendipine with atenolol, treatment of combination of metforminwith nitrendipine and atenolol may control blood pressure more efficiently, preventedbody weight gaining, and has beneficial effect on improving insulin sensitivity,kidney function and carbohydrate metabolism in EH patients. Conclusion Thesesuggested that the combination of metformin with nitrendipine and atenolol maybe a good medicine compounding.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2004年第5期332-336,共5页
The Chinese Journal of Clinical Pharmacology
