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Title:: Effects of enalapril and losartan on insulin resistance and endothelial function in essential hypertension patients with diabetes mellitus

作者:: 马元; 沈艺; 郑欢; 宋浩明; 罗明; 同济大学附属同济医院心内科，上海 200065

Author(s):: MA Yuan; SHEN Yi; ZHENG Huan; SONG Haoming; LUO Ming; Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065,China

关键词:: 高血压; 糖尿病; 胰岛素抵抗; 内皮功能; 氯沙坦; 依那普利

Keywords:: essential hypertension; diabetes mellitus; insulin resistance; endothelial function; losartan; enalapril

分类号:: R544.1

DOI:: -

文献标识码:: A

摘要:: 目的探讨氯沙坦联合依那普利对老年高血压并发糖尿病患者胰岛素抵抗及内皮功能的影响。方法选择符合标准的原发性高血压并发Ⅱ型糖尿病的患者58例，口服氯沙坦及依那普利治疗12周，分别于用药前后检测血管内皮依赖性舒张功能（EDD）、空腹及餐后2 h的血糖、血清胰岛素及C肽、胰岛素敏感指数（ISI）及胰岛素抵抗指数（HOMAIR）等，并与单纯服用氯沙坦的患者进行比较。结果氯沙坦联合依那普利治疗12周后，患者的收缩压和舒张压，均较单纯氯沙坦治疗组降得更低；EDD较单纯氯沙坦治疗组的改善更为明显；空腹、餐后2 h血糖、胰岛素及C肽的水平，均较单纯氯沙坦治疗组降低；空腹、餐后ISI，均较单纯氯沙坦治疗组显著升高，而HOMAIR则下降。结论氯沙坦联合依那普利治疗较单纯氯沙坦治疗能更有效地降压和改善胰岛素抵抗以及EDD。

Abstract:: AIM To investigate the effects of losartan and enalapril on the endothelial function and insulin resistance in patients with essential hypertension and diabetes mellitus type Ⅱ. METHODS We measured endotheliumdependent vasodilation (EDD) in brachial artery, fasting blood glucose, postprandial2hour blood glucose, serum insulin, C peptide, insulin sensitive index (ISI) and HOMAIR in 58 patients with essential hypertension and diabetes mellitus type 2 before and after a 12week treatment with losartan and enalapril and compared the results with those in patients treated only with losartan. RESULTS After the 12week treatment, SBP and DBP in patients treated with losartan and enalapril more decreased than those treated with losartan only. Their fasting blood glucose, postprandial2hour blood glucose, C peptide and HOMAIR were more reduced but ISI was significantly increased compared with those in control group. Basic diameter and flow mediated dilatation (FMD) of brachial artery were improved. CONCLUSION Treatment with losartan and enalapril decreases blood pressure and improves endotheliumdependent vasodilation in brachial artery and insulin resistance more effectively than treatment with losartan only.

参考文献/References

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