高血压伴胰岛素抵抗降压调脂治疗的干预研究

目的观察硝苯地平控释片及血脂康对高血压伴胰岛素抵抗患者相关参数的影响。方法将55例高血压伴胰岛素抵抗患者随机分为单纯降压组和降压调脂组，两组均给予硝苯地平控释片，但后者加用血脂康胶囊。治疗前后行口服糖耐量实验、胰岛素释放实验、血压监测和血脂分析，观察治疗前后两组间血糖、血胰岛素、血脂、血压及胰岛素敏感指数的变化。结果用药后两组空腹血糖、空腹胰岛素及餐后2h胰岛素均无显著性下降。降压调脂组餐后2h血糖下降显著，与单纯降压组比较有显著差异。两组用药前后胰岛素敏感指数均有一定升高，以降压调脂组为著，但两组比较差异无显著性。降压调脂组治疗后总胆固醇和甘油三酯显著降低。两组降压作用相似。结论单纯降压和降压调脂都能够改善高血压患者胰岛素抵抗，以降压调脂更为明显，但短期治疗不能使胰岛素敏感性恢复正常。长期治疗可能获得预期效果。

Effect of antihypertension and dyslipidemia on essential hypertension complicated with insulin resistance

Objective To observe the effect of nifedipine and xuezhikang on related parameters in essential hypertension patients with insulin resistance(IR).Methods 55 patients with IR were randomly divided into nifedipine group and nifedipine-xuezhikang group,who were given nifedipine but the letter was added xuezhikang.OGT and IR were conducted,and blood pressure and blood lipid were analyzed for the observation of blood glucose,insulin,blood lipid,blood pressure and insulin sensitive index.Results There was no significant difference in fasting blood glucose,fasting insulin,2h insulin between groups.2 h blood glucose was significantly decreased in nifedipine-xuezhkang group,with significant difference from nifedipine group.The insulin index was increased in both groups.Total cholesterol and triglyceride were remarkably decreased in nifedipine-xuezhikang group.The effect of antihypertension was similar in both groups.Conclusion Hypertension-induced insulin resistance can be improved in the two groups,but which is remarkable in nifedipine-xuezhikang group.Short-term treatment can not normalize the insulin sensitive index,while long-term treatment can obtain predicted results.