摘要
目的比较氨氯地平、硝苯地平和培哚普利对高血压病人胰岛素敏感性的影响及对血脂的干预作用。方法１０５例高血压病人，随机分为３组，分别用氨氯地平、硝苯地平、培哚普利治疗４周。以正常血糖胰岛素钳夹技术测定葡萄糖代谢率（Ｍ值）作为胰岛素敏感性指标。并观察血压变化。结果（１）３组病人治疗后血压均较治疗前有显著降低（Ｐ＜０．０１）；（２）合并胰岛素敏感性降低的病人治疗后Ｍ值均有明显增加。氨氯地平组治疗前后分别为４．６±０．６、６．６±１．４ｍｇｋｇ－１ｍｉｎ－１，（Ｐ＜０．０１）；硝苯地平组治疗前后分别为４．４±０．６、５．２±１．２ｍｇｋｇ－１ｍｉｎ－１（Ｐ＜０．０５）；培哚普利组治疗前后分别为：４．４±０．６、６．８±１．６ｍｇｋｇ－１ｍｉｎ－１（Ｐ＜０．０１）。结论培哚普利和氨氯地平均可明显改善胰岛素敏感性降低的高血压病人的胰岛素敏感性，硝苯地平对胰岛素敏感性的作用明显比氨氯地平和培哚普利低，短期治疗对血脂代谢均无明显影响。
Objective To investigate the effect of amlodipine,nifedipine and perindopril on insulin sensitivity(IS) and blood lipid of patients with essential hypertension(EH).Methods 105 EH patients were randomly divided into 3 groups:amlodipine group;nifedipine group;perindopril group.Treatment period lasted for 4 weeks. Before and after treatment, IS was measured by euglycemic insulin clamp technique with glucose metabolism rate (M) as an index of IS.Results Amlodipine,nifedipine and perindopril significantly reduced blood pressure compared with that before treatment( P <0.01). In the EH patients with decreased IS,the M value (mg·kg -1 ·min -1 ) after the use of amlodipine,nifedipine and perindopril was higer than that before treatment(amlodipine: 6.6±1.5 Vs 4.6±0 6, P <0.01;nifedipine:5.2±1.2 Vs 4.4±0.6, P <0.05;perindopril: 6.8±1.6 Vs 4.4±0 6, P <0.01). The increase of M value(mg·kg -1 ·min -1 ), nifedipine (1.2±0.9) were significantly lower than that of amlodipine(2.1±1.1) and perindopril(2.4±1.5), P <0.01, respectively, but no significant difference was found between amlodipine and perindopril( P >0.05).Conclusion Amlodipine and perindopril have beneficial effect on improving insulin sensitivity in EH patients with decreased insulin sensitivity. The effect of nifedipine on insulin sensitivity is lower than that of amlodipine and perindopril. Blood lipid is not significantly changed after short treatment.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1998年第3期200-202,共3页
National Medical Journal of China
基金
福建省卫生厅科研基金
