脑心通胶囊对老年高血压伴糖尿病患者左室肥厚的影响

目的:探讨脑心通胶囊对老年高血压伴糖尿病患者空腹血糖、血清胰岛素、胰岛素抵抗指数及左室肥厚的影响。方法:病例90例,随机分为脑心通胶囊(口服3粒,tid)组,培哚普利(口服4~8mg.d-1)组和非洛地平缓释片(口服6~8mg.d-1)组,每组30例,均治疗12个月。治疗前、后检测空腹血糖、血清胰岛素、胰岛素抵抗指数及超声心动图,对比分析治疗前后上述指标的差异。结果:(1)与治疗前比较,3组治疗后收缩压和舒张压明显下降(P<0.05),治疗后3组间比较收缩压及舒张压差异无显著性(P>0.05);(2)脑心通胶囊治疗后空腹血糖、胰岛素、胰岛素抵抗指数,左室后壁与室间隔厚度均明显下降(P<0.05),左室质量与左室质量指数下降更显著(P<0.01);(3)培哚普利治疗后空腹血糖无明显改变,血清胰岛素水平及胰岛素抵抗指数有明显下降(P<0.05),左室后壁与室间隔厚度无明显变化,左室质量及左室质量指数下降显著(P<0.05);(4)非洛地平缓释片治疗后左室质量及左室质量指数下降显著(P<0.05),其他指标均无变化;(5)治疗后A、B两组比较空腹血糖、血清胰岛素水平及胰岛素抵抗指数、左室后壁与室间隔厚度,左室质量及左室质量指数下降差异均有显著性(P<0.05)。结论:脑心通胶囊在提高胰岛素的敏感性、改善糖代谢的同时,使老年高血压伴糖尿病患者左室肥厚显著逆转,可预防心血管疾病的发生,值得进一步研究。

Effect of Naoxintong capsules on left ventricle hypertrophy in aged patients with diabetes mellitus and essential hypertension

OBJECTIVE To explore the effect of Naoxintong capsule on left ventricular hypertrophy(LVH) and insulin resistance in aged patients with diabetes mellitus and essential hypertension.METHODSNinety aged patients with diabetes mellitus and essential hypertensione with LVH by echocardiography entered the study.Patients were randomized into the Naoxintong capsule group,perindopril group and felodipine SR group.After treatment of Naoxintong capsuls,perindoprilor and felodipine SR,pationts were followed-up for 12 months.Plasma sample was collected from each patient before and after treatment of Naoxintong,perindoprilor and felodipine SR,respectively.Then levels of cholesterol,fasting plasma glucose(FPG),insulin and homeostasis model assessment insulin resistance(HOMA-IR)were investigated.The echocardiography before and after 12 months of treatment with Naoxintong capsules,perindoprilor and felodipine SR were also examind.RESULTSData were analyzed and showed that(1) For each patient in the three groups,the systolic blood pressure and diastolic blood pressure clearly decreased(P<0.05).After the treatment,there was no significant variation between the three groups in systolic blood pressure and diastolic blood pressure(P>0.05).(2) For patients in the Naoxintong group,FPG,insulin and HOMA-IR clearly decreased(P<0.05).Left ventricular mass index decreased respectively(P<0.01).(3) For patients in perindopril group,there was no clear change in their FPG.Compared with those before treatment(P>0.05),insulin and HOMA-IR clearly decreased(P<0.05). There was no clear change for the thickness of left ventricular posterior wall and interventricular septum.But the left ventricular weight and the index of left ventricle weight decreased clearly(P<0.05).(4) For patients in the felodipine group,the left ventricle weight and the index of left ventricle weight decreased clearly(P<0.05).There were no change for the others.(5) There was significant variation for the FPG,insulin,HOMA-IR,thickness of left ventricular posterior wall and interventricular septum,left ventricle weight and the index of left ventricle weight between patients in different groups(P<0.05).CONCLUSIONNaoxintong capsule can promote insulin sensitivity,improve glucose metabolism and it is effective on left ventricle hypertrophy in aged patients with diabetes mellitus and essential hypertension.Further clinical study with randomized and controlled method is worth while to be conducted.