卡托普利对冠心病患者胰岛素抵抗的影响

目的：探讨卡托普利对冠心病患者胰岛素抵抗的影响，以及不同剂量卡托普利对胰岛素抵抗作用的差异。方法：５９例冠心病患者分为３组，分别服卡托普利６．２５ｍｇ／ｄ、１２．５０ｍｇ／ｄ、１８．７５ｍｇ／ｄ，另２０例冠心病患者为对照组不服卡托普利，４组均于试验前、试验第１、２、４周做７５ｇ葡萄糖耐量试验，测血糖、血胰岛素，计算空腹胰岛素与血糖比值、糖耐量曲线下面积及胰岛素释放曲线下面积，用配对资料ｔ检验进行数据处理。结果：服卡托普利后，血糖、血胰岛素、空腹胰岛素与血糖比值、糖耐量曲线下面积、胰岛素释放曲线下面积较试验前下降。服卡托普利剂量在１２．５０ｍｇ／ｄ和１８．７５ｍｇ／ｄ两组于服药第４周作用更明显，但两组作用相似，而服６．２５ｍｇ／ｄ组作用不明显。结论：卡托普利能改善冠心病患者的胰岛素抵抗。

Effect of Captopril on Insulin Resistance in Patients With Coronary Heart Disease

Objective:To study the effects of different dosages of captopril on insulin resistance (ISR) in patients with coronary heart disease. Methods:Oral glucose tolerance test and insulin release test in the control group( n =20),the first therapy group ( n =20,6 25 mg/d),the 2nd therapy group ( n =20,12 50 mg/d),the 3rd therapy group ( n =19,18 75 mg/d)were studied. Results:The blood glucose level,blood insulin level,fast blood insulin/glucose ratio, area under glucose tolerance curves and area under insulin release curves were reduced after taking captopril,but only the reduction of the 2nd and the 3rd therapy groups at the 4th week were significant( p<0.05 ). Conclusion:The results suggest that captopril improves the insulin resistance in patients with coronary heart disease.