卡托普利对高血压病及高血压合并2 型糖尿病降压效果比较

目的观察卡托普利对单纯高血压病(EH)及合并2型糖尿病(简称DM)的降压效果。方法对63例EH及112例EH合并DM患者用卡托普利治疗4周，其中56例EH合并DM加用二甲双胍治疗，用药前后观察血压及血糖、血脂、胰岛素敏感性（ISI）、血浆去甲肾上腺素（NE）和肾上腺素（E）及血尿酸等指标变化。结果用卡托普利治疗后，EH组血压显著下降，ISI增加，血浆NE和E浓度降低。而EH合并DM组单用卡托普利者效果不明显，除血浆NE和E浓度下降外，其余指标无显著变化。但加用二甲双胍者降压效果与EH组相同，上述各指标均明显改善。结论卡托普利对单纯EH患者疗效显著，但对EH合并DM者单用效果欠佳。当其与二甲双胍合用时，患者的高血糖和高胰岛素血症得到改善后才能真正发挥降压作用。

Effects of Captopril on the Patients with Essential Hypertension and Hypertension Complicated with Type 2 Diabetes Mellitus

Objective To investigate if there are differences of antihypertensive effect of captopril on the patients with essential hypertension(EH)alone and EH complicated with type 2 diabetes mellitus(DM). Methods Sixty three EH patients alone and 112 EH patients complicated with DM were studied. Among the patients complicated with DM, 56 cases who were treated with metformin and received captopril for 4 weeks. The changes of blood pressure,blood glucose,insulin,lipid, norepinephrine(NE),epinephrine(E)and uric acid were observed before and after treatment. Results After treatment by captopril the blood pressure was reduced and insulin sensitivity was increased in EH patients without complications,while no significant changes in EH patients with DM. After captopril in combination with metformine for 4 weeks in EH with DM,the blood pressure was significantly reduced and all examinations cited above were improved. Conclusion Captopril is suitable for EH patients without complications but not for EH patients with DM. After captopril combined with metformine resulted in the improvement of hyperglycemia and hyperinsulinemia, the anti-hypertensive effect of captopril was shown.