硝苯地平对妊娠期高血压病患者胰岛素抵抗的作用

目的：探讨硝苯地平对妊娠期高血压病（pregnancy—inducedhypertension，PIH）患者的胰岛素抵抗（insulinresistance，IR）的作用。方法：2008年8月2010年6月采用前瞻性随机对照研究方法，将143例妊娠期高血压病患者随机分为硝苯地平组（n=73）与对照组（n=70）。硝苯地平组给予硝苯地平10mgrid口服，2～3周；对照组给予盐酸拉贝洛尔片100mgbid口服，2～3周。采用稳态胰岛素抵抗指数（homeostasismodelassessmentofinsulinresistanceindex，HOMA—IR）评价胰岛素抵抗程度。结果：硝苯地平组与对照组患者的基线临床特征相似，具有可比性。与治疗前相比，两组HOMA—IR均显著降低（P〈0．05）。硝苯地平组HOMA—IR降低值大于对照组[（0．10±0．06）比（0．07±0．05），P=0．0021。结论：硝苯地平能改善PIH患者的胰岛素抵抗。

Effect of Nifedipine on Insulin Resistance in Patients with Pregnancy-Induced Hypertension

Objective： To study the effect of nifedipine on insulin resistance （IR） in patients with pregnancy-induced hypertension（PIH）. Methods：A prospective randomized controlled trial has been conducted. From August 2008 to June 2010, 143 patients with PIH were randomized into nifedipine group （n = 73） or control group （n = 70）. The patients in nifedipine group re- ceived nifedipin 10 nag rid for 2 to 3 weeks, while patients in the control group were given labetalol 100mg bid for 2 to 3 weeks. Insulin resistance was determined by homeostasis model assessment of insulin resistance （HOMA-IR） index. Results： There were no significant differences in baseline characteristics between the two groups. Compared with baseline value, HOMA-IR index decreases were observed in both groups all P〈0.05. Moreover, the nifedipine group decreased more significantly than the control group E（0.10 ± 0.06） vs. ）0.07 ± 0.05 ,P = 0. 002]. Conclusions： This study showed that nifedipine therapy can improve insulin resistance in PIH patients.