高血压病患者胰岛素抵抗与血浆RAAS相关性及药物科素亚的干预作用

目的探讨高血压患者胰岛素抵抗与血浆RAAS的相关性及血管紧张素Ⅱ受体拮抗剂科素亚对高血压病胰岛素敏感性的影响。方法选择原发性高血压患者 5 8例 ,正常对照组 30例 ,分别测定F ins、F Glu水平 ,及血浆PRA、AngⅡ、Ald活性 ,并计算ISI,探讨高血压IR与血浆RAAS相关性。并用科素亚治疗 8周。观察治疗前后F Glu、F ins及ISI的变化。结果①高血压组与正常对照组比较ISI明显降低 ,F ins明显升高 (P <0 0 5 )。②高血压患者F ins与血浆AngⅡ正相关 (r=0 4 4 ,P <0 0 5 ) ,ISI与血浆AngⅡ水平呈负相关 (r=- 0 2 8,P >0 0 5 )。③科素亚对各级EHF ins均有下降作用 ,降压治疗有效组IR有显著改善 (P <0 0 5 )。结论高血压患者存在IR ,且F ins与血浆AngⅡ水平正相关 ,提示AngⅡ可能与Hins共同参与了高血压的形成。AngⅡ受体拮抗剂科素亚能改善高血压患者的胰岛素抵抗 ,且与降压效果有关。

Relationship between insulin resistance and plasma RAAS and the effects of cozaar on insulin resistance in hypertensive patients

Ojbective To study the relationship between insulin resistance and plasma RAAS in essential hypertension and the effects of angiotensin Ⅱ receptor antagonist Cozaar on insulin resistance.Methods Fifty eight hypertensive patients and thirty normotensive subjects as a control are engaged in this study.PRA,AngⅡ,Ald are detected in hypertensive and control group with RIA and F ins(RIA)、F RIA are also determined in hypertensive patients before and after 8 weeks of Cozaar treatment,ISI is calculated by fomular ISI-Ln(1/F ins×F Glu).Results ①In essential hypertensives F ins is obviously higher and ISI is obviously lower (P<0 05) than normotensive subjects.②F ins is positively related to AngⅡ(r=0.44,P<0.05),while ISI is inversely correlated with AngⅡ(r=-0.28,P>0 05) in essential hypertension.③AngⅡ receptor antagonist Cozaar can improve insulin sensitivity and decrease F ins obviously in efficient blood pressure lowering group.Conclusions Insulin resistance exist in essential hypertension and F ins is positively related to plasma AngⅡ level.AngⅡ receptor antagonist Cozaar can inprove insulin resistance in essential hypertension on the basis of efficient antihypertensive effection.