罗格列酮与二甲双胍对2型糖尿病患者血压的影响

目的:探讨罗格列酮和二甲双胍对2型糖尿病患者血压的影响及其作用机制。方法:58例2型糖尿病患者,随机分成2组,分别口服罗格列酮(4～8mg,qd)和二甲双胍(250～500mg,tid)治疗,在试验期间不使用其它对血压有影响的药物。观察治疗前后两组患者收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、餐后2h血糖(PBG)、空腹血浆胰岛素(FINS)、餐后2h血浆胰岛素(PINS)水平,共观察12周,计算胰岛素敏感指数(ISI)和胰岛素抵抗指数(IR)。结果:罗格列酮和二甲双胍治疗后收缩压和舒张压均有明显下降(P<0.05);罗格列酮组SBP和DBP降低幅度均大于二甲双胍组(P<0.05);两组病例FBG、PBG、FINS和PINS均明显降低(P<0.05);两组胰岛素敏感性的指标ISI升高(P<0.05),胰岛素抵抗的指标IR下降(P<0.05),罗格列酮组ISI升高和IR下降幅度大于二甲双胍组(P<0.05)。结论:罗格列酮和二甲双胍在改善胰岛素抵抗、提高胰岛素敏感指数的同时,具有降低血压的作用,罗格列酮的作用优于二甲双胍。

Influence of rosiglitazone and metformin on blood pressure in treatment of patients with type 2 diabetes mellitus

AIM: To investigate the influence of insulinsensitizer (Rosiglitazone) and metformin on blood pressure in treatment of patients with type 2 diabetes mellitus. METHODS: 58 patients with type 2 diabetes mellitus were randomly assigned to two groups. Patients orally received rosiglitazone 4-8 mg, qd, or metformin 250-500 mg, tid, for 12 weeks. The patients did not take any hypotensive drug during the investigation. BP, blood glucose and insulin were measured before and after treatment. The insulin resistance index and insulin sensitive index were calculated. RESULTS: SBP and DBP decreased after treatment by rosiglitazone and metformin (P< 0.05). The decrease of blood pressure in rosiglitazone group were more than that in metformin group. FBG, PBG and FINS and PINS decreased after treatment (P< 0.05). ISI increased and IR decreased in the two groups (P< 0.05). The extents of ISI and IR in rosiglitazone group were higher than that in metformin group. CONCLUSION: Rosiglitazone and metformin can effectively decrease IR and blood pressure, and the effect of rosiglitazone is better than that of metformin.