二甲双胍对高血压病患者胰岛素抵抗作用的研究

目的观察二甲双胍对高血压病患者胰岛素抵抗(IR)的作用,以探求应用二甲双胍作为干预高血压病转归有效措施之一的可能性.方法 78例高血压病患者分为二甲双胍治疗组42例,常规治疗组36例,测定血清肌酐(Cr)、甘油三酯(TG)、胆固醇(CHO)及高密度脂蛋白(HDL)水平,同时测定空腹血糖(FPG)和血浆胰岛素(FINS)水平,并应用HOMA公式计算IR;在进行常规降压治疗的同时,二甲双胍治疗组给予二甲双胍口服,均每3个月复查1次.同时测定20例正常人作对照.结果与对照组比较,两组高血压病患者均存在FINS及TG水平升高、HDL降低及胰岛素抵抗(均P＜0.01),但两组患者之间比较无显著性差异(P＞0.05).与常规治疗组比较,二甲双胍治疗组在口服二甲双胍3个月后FINS及IR值显著降低(均P＜0.01);口服二甲双胍6个月后FINS及IR值继续降低(均P＜0.001),同时血压下降、TG降低、HDL升高,与常规治疗组比较均有显著性差异(均P＜0.05).二甲双胍治疗组在二甲双胍治疗前后的血糖水平与常规治疗组比较无显著性差异(P＞0.05).结论二甲双胍可有效改善高血压病患者胰岛素抵抗,对TG有明显调节作用,可延缓高血压的进展,而且安全、价廉,有望成为干预高血压病发展、改善其预后的一种良药.

Study on the actions of metformin on insulin resistance in patients with hypertension

Objective To observe the actions of metformin on insulin resistance(IR) in patients with hypertension,and to expore the possibility of metformin as one of the utility measures for intervention of the prognosis of hypertension.Methods Seventy-eight patients with hypertension were divided into two groups,48 patients in metformin treatment group were treated with metformin besides the routine drugs,while patients in the other group were given the routine drugs for cutting down blood pressure.The levels of Cr,TG,CHO,FBG,FINS were measured,and IR was calculated by the formula of HOMA.The observed items were reexaminated each three months.Items of 20 normal humans were measured as control.Results Compared with the normal human,the levels of FINS and TG in the two groups were increased,the level of HDL was decreased,and insulin resistance was found in the two groups(all P< 0.01);but it showed no significant difference between the two groups(P>0.05).After taking metformin for three months,the levels of FINS and IR in the metformin treatment group was much lower than those in the routine treatment group(all P< 0.01).After taking metformin for six months,blood pressure and TG in the metformin treatment group were cut down,HDL was increased,they showed significant difference against those in the routine treatment group(all P<0.05),the levels of FINS and IR were also decreased(all P<0.001).The levels of blood sugar showed no significant difference between the two groups(P>0.05).Conclusion Metformin can effectively ameliorate IR and regulate TG in patients with hypertension.It can prolong the progress of hypertension.It is safe and inexpensive.