苯扎贝特对高血压合并高甘油三酯血症患者胰岛素抵抗的影响

目的本研究用随机、对照的方法观察苯扎贝特联合降压治疗对高甘油三酯血症合并高血压患者胰岛素抵抗的影响。方法选择58例高甘油三酯血症伴原发性高血压患者随机分为两治疗组:苯扎贝特组(A组,长效硝苯地平+饮食控制+苯扎贝特)30例,对照组(B组,长效硝苯地平+饮食控制+安慰剂)28例。通过对治疗前后血压、血脂、空腹血糖、胰岛素浓度及胰岛素敏感性指数(ISI)等的变化,来观察苯扎贝特对高甘油三酯血症合并高血压患者胰岛素抵抗的影响。结果 A组在治疗后舒张压降低较B组显著;血甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)水平明显降低,高密度脂蛋白胆固醇(HDL-c)显著升高,空腹血糖及胰岛素浓度在治疗后明显降低,ISI明显升高。结论苯扎贝特可能通过改善血脂代谢紊乱,对患者的胰岛素抵抗有良性影响,并且可能对患者舒张压有额外降低作用。

Effects of Bezafibrate on insulin resistance in Hypertensive Patients with Hypertriglyceridemia

OBJECTIVE To investigate changes of insulin resistance after lipid-lowering treatment by bezafibrate in hypertensive patients with hypertriglyceridemia using calcium channel blockers (nifedipine). PATIENTS AND METHODS Fifty-eight hypertensive hypertriglyceridemic patients were enrolled in study. In random order, patients of group A (30 patients) were treated with bezafibrate, nifedipine and diatary control, and those of group B (28 patients) received placebo, nifedipine and diatary control during 8 weeks. The changes of blood pressure (BP), serum lipid, the levels of plasma glucose and insulin have been examined and compared with two groups. RESULTS The bezafibrate-treated group had a greater reduction in diastolic BP, levels of plasma glucose and insulin, and had a increase in insulin sensitive index (ISI). CONCLUSIONS Bezafibrate maybe improve the patients' insulin resistance by adjusting dyslipidemia.