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|本期目录/Table of Contents|

双氢克尿噻长期使用对高血压病患者糖代谢的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1998年第2期
页码:
74-76
栏目:
论著
出版日期:
1998-03-01

文章信息/Info

Title:
The long-term effect of Dihydrochlorothiazide on glucose metabolism of patients with primary hypertension
作者:
刘岳怀　俞 锋　单 江
浙江医科大学附属第二医院心血管内科　杭州 310009
Author(s):
Liu Yuehuai;  Yu Feng ;  Shan Jiang
Department of Cardiology, Second Affiliated Hospital, Zhejiang Medical University, Hangzhou 310009
关键词:
高血压　双氢克尿噻　糖代谢
Keywords:
hypertension　hydrochlorothiazide　glucose metabolism
分类号:
-
DOI:
-
文献标识码:
-
摘要:
为观察双氢克尿噻(DHCT) 长期使用后对高血压病患者糖代谢的影响, 我们给25例轻度高血压病患者口服DHCT 12.5 mg, 每d两次, 持续观察3年时间, 每隔1腹及餐后2 h 血糖和空腹及餐后2 h血清胰岛素水平, 并同时测定血清K+ 、血清总胆固醇(TC) 及血清总甘油三脂(TG)。每隔两周观察1次血压变化情况。结果发现DHCT 的近期及远期降压效果均较理想, 20/25 的患者血压控制在正常范围。并发现口服DHCT 1年后高血压病患者的血糖及血清胰岛素水平均较治疗前显著升高(P < 0.05)。说明长期使用DHCT确能升高高血压病患者的血糖水平、降低糖耐量和降低其对胰岛素的敏感性。但继续治疗并未发现血糖及胰岛素水平的进一步升高,也未发现糖尿病的临床表现。观察过程中未发现血清K+ 、血清TC及TG有显著性改变。认为使用小剂量DHCT是一种长期、安全和有效的抗高血压疗法。
Abstract:
To investigate the long-term effect of Dihydrochlorothiazide (DHCT) on glucose metabo lism , we treated 25 patients with primary hyprtension using DHCT (12.5mg) twice daily for 3 years. Every other year, the blood glucose and serum insulin levels were measured after fasting and two hours post-prandial, and the serum potassium , cholesteral, triglyceride were also measured at the same time. The results indicate that DHCT has both short-term and long-term effects of lowering blood pressure, and 20/25 patients′blood pressure were controlled in normal range. The glucose level and serum insulin level were significantly elevated (P < 0.05) after 1 year′s treatment with oral DHCT, but no further elevation was observed after 2 and 3 years′treatment. There were no significant changes of serum potassium , cholesteral and triglyceride.No patients developed clinical significant dibetes mellites. These results suggest that using low dose of DHCT is an effective safe and longterm antihypertensive therapy.

参考文献/References

［1］Pollar T , Lamontanara G, Horal WH, et al. A comparison of the effects of hydrochorothiazide and captopril on glucose and lipid metablism in patients with hypertension. N Engl J Med , 1989; 321: 868.

［2］李虹伟, 顾复生, 罗春苏, 等. 冠心病病人胰岛素抵抗状态. 中华心血管病杂志, 1995; 23: 43.

［3］Weir MR, Flack JM , Applegate WB, et al. Tolerability, safety, and quality of life and hypertensive therapy,the cases for low-dose diuretics. Am J Med , 1996; 101(3A ) : 83s.

［4］De Cesaris R, Ranieri G, Filitti V , et al. Glucose and lipid metabolism in essential hypertension. Cardiology ,1993; 83 (3) : 165.

［5］Rapapol M , Franz M , Tani T , et al. Thiazide-induced glucose intolerance treated with potassium. Arch Intern Med , 1985; 113: 405.

［6］Weinberger MH, Weidmann P, Ferrari P, et al. Mechanism of the diuretic effects on carbohydrate intolerance,insulin sensitivity and lipid levels. Eur Heart J , 1992;13 (Suppl G) : 5.

备注/Memo

备注/Memo:
(收稿1997-10-20　修回1997-12-25)
更新日期/Last Update: 1998-03-01