硝苯地平对高血压胰岛素敏感性的影响

目的探讨硝苯地平对高血压（ＥＨ）患者胰岛素敏感性的影响。方法应用钙拮抗剂硝苯地平治疗老年ＥＨ患者，治疗前后行口服葡萄糖耐量试验测血糖（ＳＧ）及血胰岛素（ＩＳ）浓度，求出两者曲线下面积（ＡＵＣ），并计算ＩＳ敏感性。结果ＥＨ患者无论有无糖耐量异常，均可见ＩＳ敏感性降低和糖负荷高ＩＳ血症，糖耐量减低组表现更明显。用硝苯地平治疗后，随着血压被降至正常，症状消失，糖耐量减低组空腹及糖负荷后的ＳＧ和ＩＳ水平以及两者ＡＵＣ均较治疗前降低，ＩＳ敏感性增加，糖耐量改善。而糖耐量正常组除糖负荷后１ｈ、２ｈ血ＩＳ水平较前降低外，糖耐量及ＩＳ敏感性无显著变化。结论硝苯地平可改善伴糖耐量减低的ＥＨ患者的糖耐量及ＩＳ抵抗，增强其ＩＳ敏感性

Effect of Nifedipine Therapy on Insulin Sensitivity in Patients with Essential Hypertension

Aim To study the effect of nifedipine therapy on insulin sensitivity in patients with essential hypertension. Methods Blood glucose(SG),insulin(IS), their area under the curve(AUC)and IS sensitivity were measured during oral glucose tolerance test before and after nifedipine treatment in 43 cases of essential hypertension. Results Whether glucose tolerance was impaired or not, IS resistance was found in EH patients. Hyperinsulinemia after the oral glucose load were more pronounced in the glucose intolerance group. After nifedipine administration, fasting SG and IS concentrations and their AUC after the oral glucose load were significantly decreased. IS sensitivity was improved with blood pressure decreased concomitantly in the glucose intolerance groups. No significant difference was found in glucose tolerance and IS sensitivity in normal glucose tolerane group before and after treatment, except in whom the IS concentration was decreased at 1 and 2 hour. Conclusion Nifedipine could improve glucose tolerance and IS resistance in EH patients with impaired glucose tolerance.