摘要
目的 :研究长期服用福辛普利对高血压患者肥胖度、胰岛素敏感性、β细胞胰岛素分泌功能、血脂和血糖等的影响。方法 :4 4例轻中度原发性高血压 (EH)患者口服福辛普利 14个月 ,以根据Cederholm公式计算胰岛素敏感指数 (ISI)为胰岛素敏感性指标 ,口服葡萄糖耐量试验开始 30min后胰岛素和血糖变化的比值 (△I3 0 /△G3 0 )为 β细胞胰岛素分泌功能指标 ,观察血压、体质指数 (BMI)、腰围 /臀围比 (WHR)、血糖、血脂等的变化。 结果 :EH患者治疗后血压显著下降 ,BMI(治疗前后分别为 2 7.4± 2 .8和 2 6 .8± 3.0 ,P <0 .0 1)显著下降 ,WHR稍下降 (治疗前后分别为 0 .932± 0 .0 72和 0 .92 8± 0 .0 72 ,P >0 .0 5 ) ,ISI(治疗前后分别为 5 2 .2± 15 .8和 5 8.7±18.6 ,P <0 .0 1)和△I3 0 /△G3 0 (治疗前后分别为 2 0 .0± 17.9和 2 6 .6± 2 6 .5 ,P <0 .0 5 )显著提高 ,血糖和血脂显著下降。结论 :长期服用福辛普利能降低EH患者肥胖度 ,延缓脂肪分布的衰老性变化 ,改善胰岛素敏感性和 β细胞胰岛素分泌功能 ,改善糖代谢和血脂代谢。
Objective: To investigate the effect of long-term treatment with fosinopril on degree of obesity, insulin sensitivity, β-cell secretory function and metabolism in patients with essential hypertension (EH). Method: Forty-four patients with mild to moderate EH were treated with fosinopril for 14 months. Before and after treatment, the insulin sensitivity was measured by calculating insulin sensitivity index (ISI) according to Cederholm' formula and β-cell secr-etory function was measured by calculating the ratio of change in insulin to change in glucoseduring the first 30 min after glucose ingestion (△I 30/△G 30). Result:①Fosinopril significantly reduced blood pressure compared with that before treatment [SBP: (148±11) mm Hg vs (129±13) mm Hg , P< 0.01; DBP: (95±5) mm Hg vs (83±8)mm Hg , P< 0.01]. ②After treatment, body weight index (BMI) significantly decreased [( 27.4± 2.8) vs ( 26.8± 3.0),P< 0.01]. Waist-hip ratio decreased slightly[( 0.932± 0.072)vs ( 0.928± 0.072), P> 0.05]. Both ISI and △I 30/△G 30 were improved markedly [ ( 52.2± 15.8) vs ( 58.7± 18.6), P< 0.01; ( 20.0± 17.9) vs ( 26.6± 26.5), P< 0.05]. Fasting glucose, 1 h glucose and 2 h glucose after oral glucose tolerance test decreased markedly. Total cholesterol, triglycerides and low density lipoprotein-cholesterol significantly decreased. High density lipoprotein-cholesterol increased markedly. Conclusion:Long-term treatment with fosinopril is able to reduce degree of obesity, delay aging change of fat distribution, and has beneficial effect on improving insulin sensitivity, β-cell secretory function, carbohydrate and lipid metabolism in EH patients.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2004年第6期339-342,共4页
Journal of Clinical Cardiology
