摘要
目的通过观察吡格列酮治疗前后血管内皮功能指标的变化,探讨其对原发性高血压(EH)合并糖耐量减低(IGT)患者血管内皮功能的影响。方法筛选41例EH合并IGT患者作为实验组,给予盐酸吡格列酮(TZD)30mg,每日早上一次顿服,同时进行降压治疗,一共持续12周。在治疗前后测量受试者血压、空腹血糖(FPG)、空腹血胰岛素(FINS)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂、采用稳态模型法计算胰岛素抵抗指数(IRI),IRI=(空腹血糖×空腹胰岛素)/22.5,同时测量治疗前后血清一氧化氮(NO)、内皮素-1(ET-1)水平。结果实验组经过TZD30mg每日早上一次顿服治疗12周后,ET、HbA1c、IRI较治疗前明显下降(P<0.01),NO明显提高(P<0.01)。结论 TZD可以改善胰岛素抵抗(IR),降低血糖水平改善内皮功能,打断IR与血管内皮功能之间的恶性循环,从而起到预防和治疗心脑血管疾病的作用。
Objective To study impacts of Pioglitazone（TZD） on vascular endothelial function of the patients with essential hypertension complicated and glucose tolerance （EH＆IGT） by observing the changes of vascular endothelial function indicators before and after the treatment with Pioglitazone（TZD）. Methods Choosing 41 patients with EH ＆ IGT as an experimental group, making treatment with Pioglitazone（TZD） 30 mg once every morning and making blood-pressure-lowering treatment at the same time for 12 weeks.Measuring the patients＇blood pressure,fasting plasma glucose Level（FPG）, fasting insulin（FINS）, 2 h postprandial blood glucose（2 hPG）, glycosylated hemoglobin （HbA1 c）, blood fat before and after treatment. Calculating insulin resistance index（IRI） with Homeostasis model assessment, IRI=（FPG×FINS）/22.5.Measuring the patients＇ serum level of nitric oxide （NO）, endothelin-1 （ET-1） before and after treatment. Results After treatment（12 weeks）, ET, HbA 1 c, IRI have been decreased greatly （P〈0.01）, No has been increased greatly （P〈0.01）. Conclusion Pioglitazone（TZD） can reduce insulin resistance （IR）, decrease blood glucose level,improve endothelial function,and break vicious circle between IR and the damage of vascular endothelial function. So TZD can prevent and treat cardiovascular and cerebrovascular diseases.
出处
《当代医学》
2013年第15期42-44,共3页
Contemporary Medicine
基金
广东省医学科学技术研究基金(B2012395)
关键词
原发性高血压
糖耐量减低
胰岛素抵抗
血管内皮功能
Essential hypertension
Impaired glucose tolerance
Insulin resistance
Vascular endothelial function
